BMJ Open. 2018 Aug 23;8(8):e021787. doi: 10.1136/bmjopen-2018-021787.
Diagnostic accuracy of point shear wave elastography and transient elastography for staging hepatic fibrosis in patients with non-alcoholic fatty liver disease: a meta-analysis.
Jiang W1,2, Huang S1,2, Teng H1,2, Wang P1,2, Wu M1,2, Zhou X1,2, Ran H1,2.
Author information
1
Ultrasound Department, Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
2
Ultrasound Department, Chongqing Key Laboratory of Ultrasound Molecular Imaging, Chongqing, China.
Abstract
OBJECTIVE:
This study aimed to assess the accuracy of staging liver fibrosis in patients with non-alcoholic fatty liver disease (NAFLD) usingpoint shear wave elastography (pSWE) and transient elastography (TE).
SETTING:
Relevant records on NAFLD were retrieved from PubMed, Embase, Web of Science and the China National Knowledge Infrastructure databases up to 20 December 2017. A bivariate mixed-effects model was conducted to combine sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and area under the summary receiver operating characteristic curve (AUC) between pSWE and TE. A sensitivity analysis was implemented to explore the source of heterogeneity.
PARTICIPANTS:
Patients with NAFLD who had a liver stiffness measurement using pSWE and TE before liver biopsy were enrolled according to the following criteria: 2×2 contingency tables can be calculated via the reported number of cases; sensitivity and specificity were excluded according to the following criteria: history of other hepatic damage, such as chronic hepatitis C, concurrent active hepatitis B infection, autoimmune hepatitis, suspicious drug usage and alcohol abuse.
RESULTS:
Nine pSWE studies comprising a total of 982 patients and 11 TE studies comprising a total of 1753 patients were included. For detection of significant fibrosis, advanced fibrosis and cirrhosis, the summary AUC was 0.86 (95% CI 0.83 to 0.89), 0.94 (95% CI 0.91 to 0.95) and 0.95 (95% CI 0.93 to 0.97) for pSWE, and the summary AUC was 0.85 (95% CI 0.82 to 0.88), 0.92 (95% CI 0.89 to 0.94) and 0.94 (95% CI 0.93 to 0.97) for TE, respectively. The proportion of failure measurement was over tenfold as common with TE using an M probe compared with pSWE.
CONCLUSION:
pSWE and TE, providing precise non-invasive staging of liver fibrosis in NAFLD, are promising techniques, particularly for advanced fibrosis and cirrhosis.
截至2017年12月20日，从PubMed，Embase，Web of Science和中国国家知识基础设施数据库检索到NAFLD相关记录。采用双变量混合效应模型，结合敏感性，特异性，阳性似然比，阴性似然比和面积在pSWE和TE之间的汇总接收器操作特性曲线（AUC）下。实施敏感性分析以探索异质性的来源。
对象：