Establishment of risk assessment for liver resection by liver stiffness measurement with acoustic radio force impulse (ARFI)

我们旨在通过前瞻性分析200例接受肝切除术患者的临床数据，评估基于声辐射力脉冲（ARFI）的肝脏硬度测量对预测术后肝功能衰竭（PHLF）的有用性。单因素分析显示，ARFI测量的肝硬度值是预测PHLF最有效的指标之一，也是病理性肝纤维化程度的良好指标。为了提高预测准确性，我们进一步进行了多变量分析，并建立了一个新的公式，通过4个重要因素的组合来定量估计PHLF的风险：肝硬度，血小板计数，总胆红素和残余肝体积率。验证了该公式的有效性，提示该公式可用于临床。

We aimed to assess the usefulness of liver stiffness measurement based on Acoustic Radiation Force Impulse (ARFI) for the prediction of posthepatectomy liver failure (PHLF) by prospectively analyzing clinical data of 200 patients who underwent hepatic resection. Univariate analysis revealed that liver stiffness value measured by ARFI was one of the most efficient markers in predicting PHLF as well as an excellent indicator of the grade of pathological liver fibrosis. To improve the predictive accuracy, we further performed multivariate analysis and established a novel formula that quantitatively estimates the risk of PHLF by combination of 4 significant factors: liver stiffness, platelet count, total bilirubin, and remnant liver volume rate. The validity of the formula was verified, suggesting it could be applied to clinical use in the future.