穴位剪切波弹性成像和瞬时弹性成像对非酒精性脂肪性肝病

StephenW

BMJ Open. 2018 Aug 23;8(8):e021787. doi: 10.1136/bmjopen-2018-021787.
Diagnostic accuracy of point shear wave elastography and transient elastography for staging hepatic fibrosis in patients with non-alcoholic fatty liver disease: a meta-analysis.
Jiang W1,2, Huang S1,2, Teng H1,2, Wang P1,2, Wu M1,2, Zhou X1,2, Ran H1,2.
Author information

1
    Ultrasound Department, Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
2
    Ultrasound Department, Chongqing Key Laboratory of Ultrasound Molecular Imaging, Chongqing, China.

Abstract
OBJECTIVE:

This study aimed to assess the accuracy of staging liver fibrosis in patients with non-alcoholic fatty liver disease (NAFLD) usingpoint shear wave elastography (pSWE) and transient elastography (TE).
SETTING:

Relevant records on NAFLD were retrieved from PubMed, Embase, Web of Science and the China National Knowledge Infrastructure databases up to 20 December 2017. A bivariate mixed-effects model was conducted to combine sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and area under the summary receiver operating characteristic curve (AUC) between pSWE and TE. A sensitivity analysis was implemented to explore the source of heterogeneity.
PARTICIPANTS:

Patients with NAFLD who had a liver stiffness measurement using pSWE and TE before liver biopsy were enrolled according to the following criteria: 2×2 contingency tables can be calculated via the reported number of cases; sensitivity and specificity were excluded according to the following criteria: history of other hepatic damage, such as chronic hepatitis C, concurrent active hepatitis B infection, autoimmune hepatitis, suspicious drug usage and alcohol abuse.
RESULTS:

Nine pSWE studies comprising a total of 982 patients and 11 TE studies comprising a total of 1753 patients were included. For detection of significant fibrosis, advanced fibrosis and cirrhosis, the summary AUC was 0.86 (95% CI 0.83 to 0.89), 0.94 (95% CI 0.91 to 0.95) and 0.95 (95% CI 0.93 to 0.97) for pSWE, and the summary AUC was 0.85 (95% CI 0.82 to 0.88), 0.92 (95% CI 0.89 to 0.94) and 0.94 (95% CI 0.93 to 0.97) for TE, respectively. The proportion of failure measurement was over tenfold as common with TE using an M probe compared with pSWE.
CONCLUSION:

pSWE and TE, providing precise non-invasive staging of liver fibrosis in NAFLD, are promising techniques, particularly for advanced fibrosis and cirrhosis.

© Author(s) (or their employer(s)) 2018. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
KEYWORDS:

hepatobiliary disease; hepatology; ultrasound

PMID:
    30139901
DOI:
    10.1136/bmjopen-2018-021787

StephenW

BMJ公开赛。 2018年8月23日; 8（8）：e021787。 doi：10.1136 / bmjopen-2018-021787。
穴位剪切波弹性成像和瞬时弹性成像对非酒精性脂肪性肝病患者肝纤维化分期的诊断准确性：荟萃分析。
江W1,2，黄S1,2，滕H1,2，王P1,2，吴M1,2，周X1,2，冉H1,2。
作者信息

1
    重庆医科大学附属第二医院超声科，重庆
2
    超声科，重庆市超声分子成像重点实验室，重庆，中国。

抽象
目的：

本研究旨在评估使用点剪切波弹性成像（pSWE）和瞬时弹性成像（TE）对非酒精性脂肪性肝病（NAFLD）患者进行肝纤维化分期的准确性。
设置：

截至2017年12月20日，从PubMed，Embase，Web of Science和中国国家知识基础设施数据库检索到NAFLD相关记录。采用双变量混合效应模型，结合敏感性，特异性，阳性似然比，阴性似然比和面积在pSWE和TE之间的汇总接收器操作特性曲线（AUC）下。实施敏感性分析以探索异质性的来源。
对象：

根据以下标准登记在肝活检前使用pSWE和TE进行肝硬度测量的NAFLD患者：可通过报告的病例数计算2×2列联表;根据以下标准排除敏感性和特异性：其他肝损伤的病史，如慢性丙型肝炎，并发活动性乙型肝炎感染，自身免疫性肝炎，可疑药物使用和酒精滥用。
结果：

共纳入9项pSWE研究，包括总共982名患者和11项TE研究，共包括1753名患者。为检测显着的纤维化，晚期纤维化和肝硬化，pSWE的总AUC为0.86（95％CI 0.83-0.89），0.94（95％CI 0.91-0.95）和0.95（95％CI 0.93-0.97），总结TE的AUC分别为0.85（95％CI 0.82-0.88），0.92（95％CI 0.89-0.94）和0.94（95％CI 0.93-0.97）。与pSWE相比，使用M探针的TE的失败测量比例超过10倍。
结论：

pSWE和TE，提供NAFLD中肝纤维化的精确非侵入性分期，是有前途的技术，特别是对于晚期纤维化和肝硬化。

©作者（或其雇主）2018。CC BY-NC允许的重新使用。没有商业再利用。请参阅权限。由BMJ发布。
关键词：

肝胆疾病;肝病;超声

结论：
    30139901
DOI：
    10.1136 / bmjopen-2018-021787