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标题: 乙型肝炎相关肝硬化门静脉高压症:二维剪切波弹性成像对 [打印本页]

作者: StephenW    时间: 2019-1-1 17:36     标题: 乙型肝炎相关肝硬化门静脉高压症:二维剪切波弹性成像对

Hepatol Res. 2018 Dec 29. doi: 10.1111/hepr.13306. [Epub ahead of print]
Portal hypertension in Hepatitis B related Cirrhosis: Diagnostic accuracy of Liver and Spleen stiffness by two-dimensional Shear-wave elastography.
Zhu Y1, Ding H1,2, Fu T1,2, Peng S1, Chen S3, Luo J4, Wang W1.
Author information

1
    Departments of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, 200032, China.
2
    Shanghai Institute of Medical Imaging, Fudan University, Shanghai, 200032, China.
3
    Departments of Gastroenterology, Zhongshan Hospital, Fudan University, Shanghai, 200032, China.
4
    Departments of Interventional Radiology, Zhongshan Hospital, Fudan University, Shanghai, 200032, China.

Abstract
AIM:

To assess the diagnostic accuracy of liver and spleen stiffness measured by two-dimensional shear-wave elastography (2-D SWE) in evaluation of clinically significant and severe portal hypertension (CSPH and SPH).
METHODS:

Clinical data of 155 hepatitis B related cirrhosis patients and their liver and spleen stiffness (L-SWE and S-SWE) were collected. The diagnostic performances of L-SWE, S-SWE, the liver stiffness-spleen-diameter-to-platelet-ratio score (LSPS) and PH risk score were evaluated.
RESULTS:

104 patients were eligible for analysis. CSPH and SPH were detected in 84 and 74 patients respectively. L-SWE and S-SWE were significantly correlated with HVPG in overall, CSPH and SPH groups (rL =0.607, 0.554 and 0.412; rS =0.665, 0.566 and 0.467 respectively; all P<0.05). The AUROCs of L-SWE, S-SWE, LSPS and PH risk score were 0.72 (95%Cl, 0.49-0.95), 0.81 (95%Cl, 0.55-0.97), 0.76 (95%Cl, 0.51-0.96), 0.73 (95%Cl, 0.55-0.88) for CSPH and 0.77 (95%Cl, 0.51-0.93), 0.85 (95%Cl, 0.59-0.96), 0.80 (95%Cl, 0.58-0.98), 0.80 (95%Cl, 0.59-0.93) for SPH. The best cut-off of L-SWE for determining CSPH and SPH were 16.1 kPa (Sensitivity, 78%; Specificity, 72%) and 23.5 kPa (Sensitivity, 81%; Specificity, 79%). For S-SWE, the best cut-offs were 25.3 kPa (Sensitivity, 85%; Specificity, 79%) and 33.4 kPa (Sensitivity, 74%; Specificity, 70%). A cut-off of L-SWE < 13.2 kPa or S-SWE < 23.2 kPa was able to rule-out CSPH while a cut-off of L-SWE > 24.9 kPa or S-SWE > 34.2 kPa was able to rule-in CSPH.
CONCLUSIONS:

liver and spleen stiffness measured by 2-D SWE are reliable and promising non-invasive parameters to assess CSPH and SPH.

This article is protected by copyright. All rights reserved.
KEYWORDS:

clinically significant portal hypertension; hepatic vein pressure gradient; severe portal hypertension; shear-wave elastography; stiffness

PMID:
    30597744
DOI:
    10.1111/hepr.13306


作者: StephenW    时间: 2019-1-1 17:36

Hepatol Res。 2018年12月29日doi:10.1111 / hepr.13306。 [提前打印]
乙型肝炎相关肝硬化门静脉高压症:二维剪切波弹性成像对肝脏和脾脏硬度的诊断准确性。
朱Y1,丁H1,2,傅T1,2,彭S1,陈S3,罗J4,王W1。
作者信息

1
    复旦大学附属中山医院超声科,上海200032
2
    复旦大学上海医学影像研究所,上海200032
3
    复旦大学附属中山医院消化内科,上海200032
4
    复旦大学附属中山医院介入放射科,上海200032

抽象
目标:

评估二维剪切波弹性成像(2-D SWE)测量的肝脏和脾脏硬度的诊断准确性,评估临床显着和严重的门静脉高压症(CSPH和SPH)。
方法:

收集155例乙型肝炎相关肝硬化患者及其肝脾硬度(L-SWE和S-SWE)的临床资料。评估L-SWE,S-SWE,肝硬度 - 脾 - 直径 - 血小板比值(LSPS)和PH风险评分的诊断性能。
结果:

104名患者符合分析条件。分别在84例和74例患者中检测到CSPH和SPH。 L-SWE和S-SWE与整体,CSPH和SPH组的HVPG显着相关(rL = 0.607,0.554和0.412; rS = 0.665,0.566和0.467;所有P <0.05)。 L-SWE,S-SWE,LSPS和PH风险评分的AUROC分别为0.72(95%Cl,0.49-0.95),0.81(95%Cl,0.55-0.97),0.76(95%Cl,0.51-0.96), C73H为0.73(95%Cl,0.55-0.88),0.77(95%Cl,0.51-0.93),0.85(95%Cl,0.59-0.96),0.80(95%Cl,0.58-0.98),0.80(95%) Cl,0.59-0.93)用于SPH。用于测定CSPH和SPH的L-SWE的最佳截止值是16.1kPa(灵敏度,78%;特异性,72%)和23.5kPa(灵敏度,81%;特异性,79%)。对于S-SWE,最佳截止值为25.3kPa(灵敏度,85%;特异性,79%)和33.4kPa(灵敏度,74%;特异性,70%)。 L-SWE <13.2 kPa或S-SWE <23.2 kPa的截止值能够排除CSPH,而L-SWE> 24.9 kPa或S-SWE> 34.2 kPa的截止值能够排除部CSPH。
结论:

通过2-D SWE测量的肝脏和脾脏硬度是评估CSPH和SPH的可靠且有前景的非侵入性参数。

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关键词:

临床上显着的门静脉高压;肝静脉压力梯度;严重门静脉高压;剪切波弹性成像;刚性

结论:
    30597744
DOI:




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