PSWE不逊色于瞬时弹性

StephenW

pSWE noninferior to transient elastography

Fraquelli M, et al. Aliment Pharmacol Ther. 2016;doi:10.1111/apt.13711.
July 19, 2016


Point quantification shear-wave elastography measured liver stiffness as accurately as transient elastography, according to recent findings published in Alimentary Pharmacology and Therapeutics.


“Point shear-wave elastography is a highly applicable, reliable and reproducible technique to assess [liver stiffness] in patients with [chronic liver disease],” Mirella Fraquelli, of the gastroenterology and endoscopy unit at Ospedale Maggiore Policlinico in Italy, and colleagues wrote. “The learning curve of this technique is similar [to] that of [transient elastography], whereas it resists the usual [transient elastography] confounders, liver fibrosis being its most important determinant of values.”

Unlike transient elastography, point quantification shear-wave elastography (pSWE) can be used by patients with ascites or obesity to assess liver stiffness. However, its applicability in patients with chronic liver disease has not been fully evaluated.

During a 2-year period, Fraquelli and colleagues assessed 186 patients with chronic liver disease who consecutively underwent pSWE, which was blindly performed by two raters. The patients also underwent transient elastography. Afterward, the researchers determined the intraclass correlation coefficient (ICC) while adjusting for age, sex, BMI, liver enzymes and liver etiology.

Using pSWE, liver stiffness was 8.1 kPa according to the first rater and 8 according to the second one. For transient elastography, liver stiffness was 8.8. The pSWE ICC was 0.89 (95% CI, 0.85-0.91) and it increased from 0.86 (95% CI, 0.81-0.9) in year 1 to 0.92 (95% CI, 0.87-0.95) in year 2. Liver fibrosis was the only independent determinant of LS on pSWE.

Researchers also measured the area under the receiver operating characteristic curve for diagnosing liver fibrosis severity. The AUROC for diagnosing a score of at least 2 was 0.77 for pSWE vs. 0.81 for transient elastography; for a score of 3 it was 0.85 vs. 0.88; and for a score of 4 it was 0.88 vs. 0.94.

“Our study adds on previous reports demonstrating that, in addition to [transient elastography], shear-wave and other similar techniques may efficiently assess [liver stiffness] in patients with [chronic liver disease] of different etiology,” Fraquelli and colleagues wrote. “Such techniques include point shear-wave elastography quantification (such as ElasPQ) and shear-wave quantification techniques, all showing the advantage over [transient elastography] of being implemented on regular U.S. equipment and allowing multiple [liver stiffness] measurements on the direct visualization of the anatomical structures.” – by Will Offit

Disclosure: Fraquelli reports no relevant financial disclosures. Please see the full study for all other researchers’ disclosures.

StephenW

PSWE不逊色于瞬时弹性

Fraquelli M，等。滋养品药理疗法。 2016年，DOI：10.1111 / apt.13711。
2016年7月19日


点定量剪切波弹性成像测量肝脏硬度尽可能精确瞬时弹性成像，根据发表在消化道药理学和治疗学的最新发现。


“点剪切波弹性成像是一种高度适用，可靠和可重复的技术评估患者[慢性肝病] [肝脏硬度]”米雷拉Fraquelli，在Ospedale马焦雷位于Policlinico在意大利的胃肠病和内窥镜检查单位和同事写道： 。 “这种技术的学习曲线类似于[于]与[瞬时弹性]，而它抵抗一般的[瞬时弹性成像]混杂因素，肝纤维化是其价值的最重要因素。”

不同于瞬时弹性成像，点定量剪切波弹性成像（PSWE​​）可以通过腹水患者或肥胖可以用来评估肝脏硬度。然而，其在慢性肝病适用性尚未完全评估。

在2年的时间，Fraquelli和同事评估186例慢性肝病患者连续谁接受PSWE，这是盲目通过两个评价​​者进行。患者还进行瞬时弹性。之后，研究人员确定而调整了性别，年龄，体重指数，肝酶和肝发病原因的组内相关系数（ICC）。

使用PSWE，肝脏硬度按照根据第二个第一评价者和8为8.1千帕。对于瞬时弹性成像，肝脏硬度为8.8。该PSWE I​​CC为0.89（95％CI，0.85-0.91），并从0.86年2.肝纤维化增加（95％CI，0.81-0.9）在今年1至0.92（95％CI，0.87-0.95）是仅在PSWE LS的独立决定。

研究人员还测量了ROC曲线用于诊断肝纤维化的严重性下的面积。用于诊断至少为2分的AUROC为0.77为PSWE与0.81瞬时弹性;一个3分是0.85 0.88对比;和用于分的4它为0.88与0.94。

“我们的研究在以前的报告表明，除了[瞬时弹性]，横波和其他类似的技术可以有效地评估患者的不同病因[慢性肝病] [肝脏硬度]补充道，”Fraquelli及其同事写道。 “这些技术包括点横波弹性量化（如ElasPQ）和横波量化技术，都显示出了对普通美国设备，并允许在直接可视化多[肝脏硬度]测量正在实施[瞬时弹性成像]优势的解剖结构。“ - 威尔Offit

披露：Fraquelli报告没有相关财务披露。请参阅其他研究人员披露了充分的研究。

csfluke

各有各的适用范围吧，我感觉瞬时弹性挺适合我的