肝脏硬度测定在肝功能及食道的评价中的作用静脉曲张肝硬

StephenW

Original article
The role of liver stiffness measurement in the evaluation of liver function and esophageal varices in cirrhotic patients

    Jing Hua1,†,
    Gui Qin Liu2,†,
    Han Bao1,
    Li Sheng1,
    Can Jie Guo1,
    Hai Li1,
    Xiong Ma1 and
    Jia Lin Shen2,*

Article first published online: 24 FEB 2015

DOI: 10.1111/1751-2980.12210

© 2014 Chinese Medical Association Shanghai Branch, Chinese Society of Gastroenterology, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine and Wiley Publishing Asia Pty Ltd

Issue
Journal of Digestive Diseases

Volume 16, Issue 2, pages 98–103, February 2015


Keywords:

    elasticity imaging techniques;
    liver cirrhosis;
    liver stiffness measurement;
    portal hypertension;
    varicose veins

Objective

We aimed to evaluate the efficacy of liver stiffness measurement (LSM) in predicting the presence and severity of esophageal varices (EV) and investigating its association with liver function (LF) in patients with liver cirrhosis.
Methods

Medical records of 90 cirrhotic patients who underwent LSM by transient elastography were retrospectively reviewed. The relationship between LSM and the presence and severity of EV was evaluated by esophagogastroduodenoscopy (EGD) and multislice spiral computed tomography (MSCT). Another 25 healthy individuals were included as controls.
Results

LSM was significantly associated with the Child–Pugh score in cirrhotic patients, with the highest LSM in those with Child–Pugh C. Patients with clinically decompensated cirrhosis had a higher LSM than those with compensated cirrhosis (36.75 ± 16.54 kPa vs 17.65 ± 10.87 kPa, P < 0.01). However, there was no significant difference in LSM value between patients with severe EV and those with no or non-severe EV determined by endoscopy (28.18 ± 17.44 kPa vs 31.00 ± 18.44 kPa) or MSCT (29.71 ± 18.39 kPa vs 24.90 ± 14.80 kPa). The diagnostic value of LSM for predicting severe EV was low in unselected cirrhotic patients. The presence of EV examined by EGD and MSCT was similar to each other.
Conclusions

LSM could be used to evaluate the progression of liver cirrhosis continuously. However, its role in assessing EV grades in advanced cirrhosis needs further confirmation. MSCT can assess EV accurately and may serve as an alternative to endoscopy in the assessment of portal hypertension.

StephenW

原创文章
肝脏硬度测定在肝功能及食道的评价中的作用静脉曲张肝硬化患者

    靖华1，†，
    秦桂刘备，†，
    韩Bao1，
    李Sheng1，
    可杰果1，
    海丽1，
    熊MA1和
    贾璃嗯Shen2，*

文章首次在网上公布：2015年2月24日

DOI：10.1111 / 1751-2980.12210

©2014年中国医师协会上海分会，消化中国社会，仁济医院隶属于上海交通大学医学院和威利出版亚洲控股有限公司

问题
中华消化病

第16卷，第2期，页98-103，2015年2月


关键词：

    弹性成像技术;
    肝硬化;
    肝脏硬度测量;
    门脉高压症;
    静脉曲张

目标

我们的目的是评估在预测食管静脉曲张的存在和严重性（EV），并调查其与肝硬化患者肝功能（LF）的关联肝脏硬度测量（LSM）的疗效。
方法：

90谁接受LSM由瞬时弹性成像肝硬化患者的医疗记录进行回顾性审查。 LSM和EV的存在和严重性之间的关系是通过胃镜（EGD）和多层螺旋CT（MSCT）进行评估。另外25名健康人作为对照。
结果

LSM是显著与Child-Pugh评分在肝硬化患者相关，在那些与Child-Pugh分级C.患者临床失代偿性肝硬化的最高LSM有较高的LSM比那些代偿期肝硬化（36.75±16.54千帕VS 17.65±10.87千帕，P <0.01）。然而，有重症患者EV和那些没有或内镜确定非重度EV之间的LSM值无差异显著（28.18±17.44千帕VS 31.00±18.44千帕）或多层螺旋CT（29.71±18.39千帕VS 24.90±14.80千帕）。 LSM的预测严重EV的诊断价值较低的未选择的肝硬化患者。电动车的存在下通过EGD和MSCT检查是彼此相似的。
结论

LSM可用于连续评估肝硬化的进展。然而，它在评估晚期肝硬化EV档次的作用还需要进一步确认。 MSCT可以准确地评估EV，可以作为一种替代的门静脉高压症的评估内镜。