1067
Shear Wave Elasticity (SWE) Unreliable in
Detection of Cirrhosis
John C. Hoefs, Medicine, University of California, Irvine
Background: Shear Wave Elasticity (SWE) by ultrasound
(US) is thought to be similar to Fibroscan in the ability to
Detect cirrhosis and predict Metavir Fibrosis (F0-F4) where
F4 is cirrhosis (Rad 276:845). Neither method of estimating
Cirrhosis measures the functional mass of the liver or
Quantitative liver function. SWE has recently become a
Routine measurement during HCC surveillance. We assess
The ability of SWE to detect cirrhosis. HYPOTHESIS: SWE
Correlate with the presence of cirrhosis. Methods: Our initial
193 patients with SWE at US were reviewed for comparison
With other clinical factors. Non-cirrhotic patients (NC) included
147 with underlying pre-cirrhotic CLD (HBV, HCV, PBC, PSC,
ACAH and miscellaneous), non-cirrhotic portal hypertension
And acute liver disease with jaundice. Cirrhotic patients (C)
Included with never having clinical complications (such as
Ascites, VB and encephalopathy) (C1=16 patients);
with complications in past, but resolved (C2=17); active
complications requiring treatment (C3=10) and those on
the liver transplant list (C4=3). All patients had a fasting US
(GE LOGIQ E9) with SWE per manufactures instructions:
shear wave velocity (SWV) and estimated METAVIR fibrosis
score (eMFS: 0-4) were recorded. Surface nodularity, spleen
length (SL) (cm) and ascites were recorded. Clinical data was
abstracted from the records. Results: SWE was attempted
in 193, but unable in 6 (3%) (NC 3, C 3). The other 187 were
included in this analysis. 144 NC were compared with 43 C:
nodularity: NC 2/144: C1 8/15; C2 14/15; C3 8/10 and C4
2/3. SL>12 CM: NC 10/144; C1 9/15; C2 6/15; C3 9/10; C4
3/3). Ascites: NC 2/144, C1 0/15; C2 2/15; C3 6/10; C4 3/3.
SWV> 1.8: NC 10/144; C1 6/15; C2 7/15; C3 6/10; C4 0/3.
eMFS > 2:NC 12/144; C1 8/15; C2 8/15; C3 7/10; C4 0/3.
76.7 % patients with C were < F4. Of the 10 NC with > F2, 3
had severe acute liver disease with jaundice and 2 had fatty
liver. The percent of patients with C in each eMFS score was
calculated and a good correlation was found with eMFS and
% with Cirrhosis (r2=.978) (figure). However, all 3 patients on
the liver transplant list (C4) had ascites and had an eMFS <3.
Conclusion: eMFS by SWE was unreliable in detecting C
with eMFS (range from 0-4), 2. eMFS F4 had a high percent
with cirrhosis, but most C had < F4, 3. NC Could have a high
eMFS usually associated with severe acute disease. 4. A
nodular liver surface correlated with the presence of cirrhosis. 作者: StephenW 时间: 2018-10-27 20:08