肝脏硬度在非酒精性脂肪肝：超音速剪切成像，肝纤维和ARFI

StephenW

Liver stiffness in nonalcoholic fatty liver disease: A comparison of Supersonic Shear Imaging, FibroScan and ARFI with liver biopsy
Authors

    Accepted manuscript online: 13 December 2015Full publication history
    DOI: 10.1002/hep.28394View/save citation
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Abstract

Non-alcoholic fatty liver disease (NAFLD) has become a major public health issue. The aim was to assess the clinical utility of liver stiffness measurement (LSM) evaluated by Supersonic Shear Imaging (SSI), FibroScan, and ARFI in a cohort of NAFLD patients who underwent liver biopsy. A total of 291 NAFLD patients were prospectively enrolled from November 2011 to February 2015 at 2 French university hospitals. LSM was assessed by SSI, FibroScan (M probe), and ARFI within two weeks prior to liver biopsy. Calculations of the area under the receiver operating curve (AUROC) were performed and compared for the staging of liver fibrosis. AUROC for SSI, FibroScan, and ARFI were 0.86, 0.82, and 0.77 for diagnoses of ≥F2; 0.89, 0.86, and 0.84 for ≥F3; and 0.88, 0.87, and 0.84 for F4, respectively. SSI had a higher accuracy than ARFI for diagnoses of significant fibrosis (≥F2) (p=0.004). Clinical factors related to obesity such as body mass index ≥30kg/m2, waist circumference ≥102cm or increased parietal wall thickness were associated with LSM failures when using SSI or FibroScan and with unreliable results when using ARFI. In univariate analysis, FibroScan values were slightly correlated with NAFLD activity score and steatosis (R=0.28 and 0.22, respectively), whereas SSI and ARFI were not; however, these components of NAFLD didn't affect LSM results in multivariate analysis. The cut-off values for SSI and FibroScan for staging fibrosis with a sensitivity ≥90% were very close: 6.3/6.2 kPa for ≥F2, 8.3/8.2 kPa for ≥F3, and 10.5/9.5 kPa for F4.

Conclusion: Although obesity is associated with an increase in LSM failure, the studied techniques and especially SSI provide high value for the diagnosis of liver fibrosis in NAFLD patients. This article is protected by copyright. All rights reserved.

StephenW

肝脏硬度在非酒精性脂肪肝：超音速剪切成像，肝纤维和ARFI与肝活检的比较
作者

    接受稿件在线：12月13日2015Full出版物历史
    DOI：10.1002 / hep.28394View /保存引文
    引述：0物品检查新引文
    文章的altmetric比分3

抽象

非酒精性脂肪性肝病（NAFLD）已成为重要的公共卫生问题。这样做的目的是评估肝脏硬度测量（LSM）的NAFLD患者谁接受肝活检的队列超音速剪切成像（SSI），肝纤维和ARFI评估的临床应用。共有291 NAFLD患者进行前瞻性入选2011年11月至2015年2月2法国大学医院。 LSM是由SSI，肝纤维（M头），并ARFI之前，肝活检的两周内进行评估。受试者工作曲线（AUROC）下面积的计算进行比较的肝纤维化分期。 AUROC为SSI，肝纤维和ARFI分别为0.86，0.82和0.77≥F2的诊断; 0.89，0.86和0.84≥F3;和0.88，0.87，和0.84 F4分别。 SSI有较高的精度比ARFI的显著纤维化（≥F2）（P = 0.004）的诊断。与肥胖相关的临床因素，如体重指数≥30kg/ m2时，腰围≥102cm或增加的顶叶壁厚均与采用SSI或肝纤维时LSM失败和不可靠的结果使用ARFI时。在单因素分析，肝纤维值略有与相关NAFLD活动评分和脂肪变性（R = 0.28和0.22，分别），而SSI和ARFI没有;然而，NAFLD的这些组件并没有影响多因素分析LSM结果。截止值SSI和肝纤维的纤维化分期与灵敏度≥90％，非常接近：6.3 / 6.2千帕的≥F2，8.3 / 8.2千帕的≥F3和10.5 / 9.5千帕的F4。

结论：尽管肥胖与增加的LSM故障相关，所研究的技术，特别是提供的SSI为肝纤维化的NAFLD患者的诊断价值高。这篇文章是受版权保护的。版权所有。