肝纤维化无创评价使用实时组织弹性和瞬时弹性（肝纤维）

StephenW

Noninvasive Evaluation of Liver Fibrosis Using Real-time Tissue Elastography and Transient Elastography (FibroScan)

    Fankun Meng, MD⇑,
    Ying Zheng, MD,
    Qi Zhang, MD,
    Xiaojie Mu, MD,
    Xiaoluan Xu, MD,
    Haiying Zhang, MD and
    Lei Ding, MD

- Author Affiliations

    Department of Ultrasound, You’an Hospital, Capital Medical University, Beijing, China (F.M., Y.Z., X.M., X.X., H.Z., L.D.); and Department of Ultrasound, Hitachi Medical Corporation, Beijing, China (Q.Z.).

    Address correspondence to Fankun Meng, MD, of Ying Zheng, MD, Department of Ultrasound, You’an Hospital, Capital Medical University, 8 Youwai Xitoutiao St, Feng Tai District, 100069 Beijing, China. E-mail: [email protected]

Abstract

Objectives—The purpose of this study was to assess liver fibrosis with real-time tissue elastography and to compare the results with those of transient elastographic (FibroScan; Echosens, Paris, France) measurements by using liver biopsy as the reference standard.

Methods—Real-time tissue elastography and percutaneous liver biopsy were performed in 166 patients with chronic hepatitis B (estimation group). The relationship between the parameters obtained via real-time tissue elastography and the hepatic fibrosis stage was evaluated by a stepwise multiple linear regression, and the regression equation was used to calculate the liver fibrosis index. The diagnostic performance of the liver fibrosis index was validated and compared with FibroScan in 121 other patients with chronic hepatitis B (validation group).

Results—The liver fibrosis index was calculated as follows: liver fibrosis index = 0.043 low-strain area ratio + 4.520 skewness + 0.033 mean – 1.002 kurtosis. The liver fibrosis index and liver stiffness measured by FibroScan were both significantly associated with the fibrosis stage in the validation group (r= 0.667 and 0.664, respectively; both P< .001). The areas under the receiver operating characteristic curves for the liver fibrosis index and liver stiffness were 0.880 and 0.909 for predicting substantial fibrosis (scores ≥F2), 0.868 and 0.874 for predicting severe fibrosis (≥F3), and 0.752 and 0.815 for predicting cirrhosis (F4), respectively.

Conclusions—Real-time tissue elastography is an effective method for assessing liver fibrosis, with diagnostic performance similar to that of transient elastography.

StephenW

肝纤维化无创评价使用实时组织弹性和瞬时弹性（肝纤维）

    犯困猛，MD⇑，
    应遮嗯，MD，
    齐查嗯，MD，
    小杰沐，MD，
    鸾许，MD，
    张海英，MD和
    雷羝嗯，MD

- 作者所属机构

    超声，佑安医院，首都医科大学，北京，中国（FM，YZ，XM，XX，HZ，LD）部;与超声，日立医疗公司，北京，中国（QZ）系。

    通讯地址犯困猛，MD，嬴政，MD，超声科，佑安医院，首都医科大学，8 Youwai Xitoutiao街，丰台区，100069中国北京。电子邮件：[email protected]

抽象

目标 - 的本研究的目的是评估肝纤维化的实时组织弹性，并比较分别与瞬时弹性成像的;通过使用肝活检作为参考标准测量（肝纤维Echosens，巴黎，法国）。

方法：实时组织弹性和经皮肝穿刺活检是在166例慢性乙型肝炎（估计组）进行。通过实时组织弹性和肝纤维化的阶段中获得的参数之间的关系是由一逐步多重线性回归评估，并回归方程来计算肝脏纤维化指数。肝纤维化指标的诊断性能进行了验证，并与在121的其他慢性乙型肝炎（验证组）肝纤维相比。

结果为肝纤维化指数计算如下：肝纤维化指数= 0.043的低应变区域比+ 4.520偏斜+ 0.033平均值 - 1.002峭度。由肝纤维测肝纤维化指标和肝脏硬度双双显著与验证组中的纤维化分期相关（r = 0.667和0.664，分别; P值均<0.001）。受试者工作特征曲线为肝纤维化指数和肝脏硬度下面积分别为0.880和0.909用于预测严重纤维化（≥F3）预测实质纤维化（分数≥F2），0.868和0.874，和0.752和0.815的预测性肝硬化（ F4）表示。

结论 - 实时组织弹性成像是一种有效的方法，用于评估肝纤维化，具有诊断性能类似于瞬时弹性的。