利用瞬时弹性成像评估肝纤维化的个体差异

肝胆速递

http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2893.2012.01608.x/abstract
Interobserver discrepancy in liver fibrosis using transient elastography

    B. Roca,
    E. Resino,
    V. Torres,
    E. Herrero,
    M. Penades

Article first published online: 27 MAR 2012

DOI: 10.1111/j.1365-2893.2012.01608.x
    Medicine Department, Hospital General of Castellon, University Jaume I and University of Valencia, Castellon, Spain

*Bernardino Roca, Catalunya, 33-A, 4, 12004 Castellon, Spain. E-mail: [email protected]

Summary.  Transient elastography is a useful method to assess liver fibrosis, but uncertainties still exist regarding reliability and reproducibility of the technique. We aimed to improve knowledge on interobserver variability with the procedure and tried to find factors associated with such variability. This was a cross-sectional study to compare the results of transient elastography performed by two different operators, one test made just after the other. We assessed both results with correlation tests and with repeated parametric or nonparametric tests, as needed. We also carried out a multivariate analysis to find factors associated with discrepancy in the results obtained by the two operators. We included a total of 333 pairs of transient elastography tests, belonging to 274 different patients. A total of 325 pairs of tests (97.6%) were valid. Results of the first and the second tests were, respectively, median (and interquartile range) of direct measurement 6.2 (4.6–10.6) and 6.0 (4.4–10.1) kPa (P = 0.012), and mean ± standard deviation of log10 of direct measurement 0.892 ± 0.316 and 0.871 ± 0.324 (P = 0.001). In 87 pairs of tests (26.7%), a discrepancy of at least 2 kPa between both results was found, and in 15 pairs of tests (4.6%), a discrepancy of at least 10 kPa was found. Discordance of at least one stage between both measurements was noted in 74 pairs of tests (22.8%). An association was found between higher stiffness and discrepancy between both operators (P < 0.001). Although transient elastography is a very convenient test to assess liver fibrosis in clinical practice, interobserver discrepancy in results is common and represents a significant problem with the technique. Discrepant results are more common in patients with higher values of stiffness.

肝胆速递

观察者之间的差异在肝纤维化瞬时弹性

    B.乐家，
    E. Resino，
    五，托雷斯，
    E.雷罗
    M. Penades

文章首次在网上公布：2012年3月27日

DOI：10.1111/j.1365-2893.2012.01608.x
    医学部，医院，海梅一世大学和瓦伦西亚大学，卡斯特利翁，西班牙卡斯特利翁

*圣贝纳迪诺乐家，加泰罗尼亚，33-A，4，12004卡斯特利翁，西班牙。电子邮件：[email protected]

总结。瞬时弹性是一个非常有用的方法来评估肝纤维化，但不确定性仍然存在的技术可靠性和可重复性。我们的目的是提高知识的程序观察者之间的差异，并试图找到这类变异的相关因素。这是一个横断面研究的结果进行比较两种不同的运营商进行瞬时弹性，刚刚结束的一个测试。我们评估了相关的测试和重复参数和非参数检验，根据需要两个结果。我们也进行了多因素分析中的两家运营商获得的结果差异的相关因素。共333对瞬时弹性测试，属于274个不同的病人。共测试325双（97.6％）是有效的。的第一和第二测试结果，分别为中位数（四分位数间距）直接测量6.2（4.6-10.6）和6.0（4.4-10.1）千帕（P = 0.012），平均±标准偏差直接的LOG10测量0.892±0.316和0.871±0.324（P = 0.001）。在87双测试（26.7％），发现两个结果之间的差异的至少2千帕，并在测试15双（4.6％），被发现的差异至少为10千帕斯卡。指出在测试74对（22.8％）中的至少一个阶段两个测量之间的偏差。更高的刚度和运营商（P <0.001）之间的差异被发现之间的关联。虽然瞬时弹性成像是一个非常方便的测试，以评估肝纤维化的临床实践中，观察者之间的差异，结果是普遍的，是一个重大的技术问题。结果不一致的刚度值较高的患者更常见。

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