瞬时弹性成像(TE)在慢性肝炎的肝硬度测量性能

StephenW

http://www.ncbi.nlm.nih.gov/pubmed/23326162
World J Gastroenterol. 2013 Jan 7;19(1):49-56. doi: 10.3748/wjg.v19.i1.49.
Performance of liver stiffness measurements by transient elastography in chronic hepatitis.Ferraioli G, Tinelli C, Bello BD, Zicchetti M, Lissandrin R, Filice G, Filice C, Above E, Barbarini G, Brunetti E, Calderon W, Gregorio MD, Gulminetti R, Lanzarini P, Ludovisi S, Maiocchi L, Malfitano A, Michelone G, Minoli L, Mondelli M, Novati S, Patruno SF, Perretti A, Poma G, Sacchi P, Zanaboni D, Zaramella M.
SourceGiovanna Ferraioli, Mabel Zicchetti, Raffaella Lissandrin, Carlo Filice, Elisabetta Above, Gianluigi Poma, Marta Di Gregorio, Ultrasound Unit, Department of Infectious Diseases, Fondazione IRCCS Policlinico San Matteo, Medical School University of Pavia, 27100 Pavia, Italy.

AbstractAIM: To compare results of liver stiffness measurements by transient elastography (TE) obtained in our patients population with that used in a recently published meta-analysis.
METHODS: This was a single center cross-sectional study. Consecutive patients with chronic viral hepatitis scheduled for liver biopsy at the outpatient ward of our Infectious Diseases Department were enrolled. TE was carried out by using FibroScan™ (Echosens, Paris, France). Liver biopsy was performed on the same day as TE, as day case procedure. Fibrosis was staged according to the Metavir scoring system. The diagnostic performance of TE was assessed by using receiver operating characteristic (ROC) curves and the area under the ROC curve analysis.
RESULTS: Two hundred and fifty-two patients met the inclusion criteria. Six (2%) patients were excluded due to unreliable TE measurements. Thus, 246 (171 men and 75 women) patients were analyzed. One hundred and ninety-five (79.3%) patients had chronic hepatitis C, 41 (16.7%) had chronic hepatitis B, and 10 (4.0%) were coinfected with human immunodeficiency virus. ROC curve analysis identified optimal cut-off value of TE as high as 6.9 kPa for F ≥ 2; 7.9 kPa for F ≥ 3; 9.6 kPa for F = 4 in all patients (n = 246), and as high as 6.9 kPa for F ≥ 2; 7.3 kPa for F ≥ 3; 9.3 kPa for F = 4 in patients with hepatitis C (n = 195). Cut-off values of TE obtained by maximizing only the specificity were as high as 6.9 kPa for F ≥ 2; 9.6 kPa for F ≥ 3; 12.2 kPa for F = 4 in all patients (n = 246), and as high as 7.0 kPa for F ≥ 2; 9.3 kPa for F ≥ 3; 12.3 kPa for F = 4 in patients with hepatitis C (n = 195).
CONCLUSION: The cut-off values of TE obtained in this single center study are comparable to that obtained in a recently published meta-analysis that included up to 40 studies.

StephenW

肝脏硬度测量结果进行比较，在我们的患者人群瞬时弹性成像（TE）在最近发表的荟萃分析。
方法：

这是一个单中心的横断面研究。连续患者的慢性病毒性肝炎肝活检定于在我们的传染科门诊病房的患者。 TE进行了肝纤维化（Echosens，巴黎，法国）。肝活检进行的同一天，TE，作为一天的情况下程序。纤维化上演根据METAVIR评分系统。通过使用接收器工作特性（ROC）曲线下的面积的ROC曲线分析评估的诊断性能的TE。
结果：

两百年和52例符合纳入标准。六（2％）患者被排除由于不可靠的TE测量。因此，246例患者（171名男性和75名女性）进行了分析。慢性丙型肝炎，41例（16.7％）和95（79.3％）患者有慢性B型肝炎，10（4.0％）合并感染人类免疫缺陷病毒。 ROC曲线分析，确定了最佳cut-off值高为6.9千帕F≥2，TE 7.9 kPa为F≥3; 9.6 kPa为F = 4，所有患者（N = 246），和高为6.9千帕F≥2，F≥7.3 kPa为9.3 kPa为F = 4，C型肝炎患者（N = 195）。临界值的TE唯一的特异性最大化获得高为6.9千帕F≥2，F≥9.6 kPa为12.2千帕为F = 4在所有患者（n = 246），高达7.0 F≥2，F≥3 9.3千帕; 12.3千帕kPa为F = 4，C型肝炎患者（N = 195）。
结论：

这种单中心研究中得到的截止值的TE是在最近出版的元分析，其中包括高达40研究得到的相媲美。