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标题: Diagnosis of liver fibrosis and cirrhosis using liver stiffness measurement: Com [打印本页]

作者: StephenW 时间: 2012-3-17 17:19 标题: Diagnosis of liver fibrosis and cirrhosis using liver stiffness measurement: Com

Research Article
Diagnosis of liver fibrosis and cirrhosis using liver stiffness measurement: Comparison between M and XL probe of FibroScan®

Victor de Lédinghen1, 2, , ,
Vincent Wai-Sun Wong3, 4,
Julien Vergniol1,
Grace Lai-Hung Wong3, 4,
Juliette Foucher1,
Shirley Ho-Ting Chu3, 4,
Brigitte Le Bail2, 5,
Paul Cheung-Lung Choi6,
Faiza Chermak1,
Karen Kar-Lum Yiu3, 4,
Wassil Merrouche1,
Henry Lik-Yuen Chan3, 4

1 Centre d’Investigation de la Fibrose Hépatique, Centre Hospitalier Universitaire (CHU) de Bordeaux, Hôpital Haut-Lévêque, France
2 Institut National de la Santé et de la Recherche Médicale U1053, Université Bordeaux Segalen, Bordeaux, France
3 Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, China
4 Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China
5 Service d’Anatomie Pathologique, CHU de Bordeaux, Hôpital Pellegrin, France
6 Department of Anatomical and Cellular Pathology, The Chinese University of Hong Kong, Hong Kong, China

Received 20 August 2011. Revised 15 October 2011. Accepted 17 October 2011. Available online 13 December 2011.

http://dx.doi.org/10.1016/j.jhep.2011.10.017, How to Cite or Link Using DOI

Background & Aims

Unreliable results of liver stiffness measurement are obtained in 16% of cases and are independently associated with body mass index (BMI) greater than 30 kg/m2. A new FibroScan® probe (XL probe) was designed specifically for obese patients. The aim of this study was to evaluate the accuracy of liver stiffness measurement using M and XL probes of Fibroscan® for the diagnosis of fibrosis and cirrhosis in a large cohort of patients.

Methods

Consecutive patients undergoing liver biopsies for chronic liver disease were prospectively recruited. Liver stiffness measurement was performed within 1 week before liver biopsy using both M and XL probes of FibroScan®.

Results

A total of 286 patients were evaluated. A reliable liver stiffness measurement using M probe was obtained in 79.7% of cases. In the other 21.3%, liver stiffness measurement using XL probe was obtained in 56.9% of patients. A strong correlation was found between M and XL values, regardless of BMI. In all groups, median liver stiffness measurement using the XL probe was significantly lower than liver stiffness measurement using the M probe. By multivariate analysis, unsuccessful liver stiffness examination with M probe was independently associated with age >50 years and BMI >30 kg/m2. By univariate analysis, only BMI >30 kg/m2 was associated with unsuccessful liver stiffness measurement with XL probe. No significant difference was observed between the M and XL probes for the diagnosis of liver fibrosis.

Conclusions

Liver stiffness measurement with either M or XL probe is possible in 91.2% of patients with comparable diagnostic accuracy. In clinical practice, the M probe could be used as first step for liver stiffness measurement. In case of no valid shot or unreliable measurement, the XL probe could be used. This result could be useful for the assessment of liver fibrosis in NAFLD and/or obese patients.

作者: StephenW 时间: 2012-3-17 17:20

研究文章
诊断肝纤维化和肝硬化肝脏硬度测量：M和XL探头FibroScan之间的比较®

维克托·Lédinghen1，2，通讯作者的联系信息，电子邮件的通讯作者，
文森特围太阳Wong3，4，
朱利安Vergniol1
格雷斯赖红Wong3，4，
朱丽叶Foucher1
雪莉何婷Chu3，4，
布里吉特·勒Bail2，5，
张国基龙Choi6
法伊扎Chermak1
卡伦家绥Yiu3，4，
wassil Merrouche1
亨利力源Chan3，4

1中心的调查德拉大学医学中心（楚）波尔多，总医院上，Lévêque，法国FibroseHépatique
2研究所国家德拉桑特ET DE LA RECHERCHEMédicaleU1053，波尔多谢阁兰大学，法国波尔多
3，香港，中国，香港中文大学消化疾病研究所
4，中国，香港，香港中文大学内科及药物治疗部
5服务D'Anatomie Pathologique，褚总医院佩列格林，法国波尔多，
6部病理解剖及细胞学，中国，香港，香港中文大学

2011年8月20收到。 2011年10月15日。 2011年10月17日接受。 2011年12月13日。

http://dx.doi.org/10.1016/j.jhep.2011.10.017，如何来引用或链接使用分类号

背景与目的

肝脏硬度测量结果不可靠，得到16％的情况下，独立与身体质量指数（BMI）大于30 kg/m2。一个新的FibroScan®探头（探头加大）专门为肥胖患者。本研究的目的是评估使用M和XL探头Fibroscan在诊断肝纤维化和肝硬化的患者大型队列®肝脏硬度测量精度。
方法

连续接受肝活检为慢性肝病患者进行了前瞻性招募。 1个星期内进行肝脏硬度测量FibroScan®M和XL探头前肝活检。
结果

共有286例患者进行了评价。 79.7％的情况下，获得了一个可靠的肝脏硬度测量使用M探针。在其他的21.3％，56.9％的患者肝脏硬度测量使用XL探头获得。发现M和XL值之间很强的相关性，无论体重。在所有群体中，正中肝脏硬度测量使用的XL探头，显着高于M探针测量肝脏硬度低。多因素分析，不成功肝与M探针刚度考试独立与年龄> 50岁和BMI> 30 kg/m2。由单因素分析，只有BMI> 30 kg/m2与的不成功肝刚度与XL探头测量。 M和XL探头之间没有显着差异，观察肝纤维化的诊断。
结论

M或XL探头肝刚度测量的诊断准确率具有可比性的患者中91.2％是可能的。在临床实践中，M探针可作为肝脏硬度测量的第一步。在没有有效的射门或不可靠的测量的情况下，XL探头可以使用。这一结果可能是有用的NAFLD和/或肥胖患者肝纤维化的评估。

作者: 9病成医 时间: 2012-3-17 19:47

谢过StephenW的资料.

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