AASLD2018[1067]剪切波弹性（SWE）不可靠 检测肝硬化

StephenW

1067
Shear Wave Elasticity (SWE) Unreliable in
Detection of Cirrhosis
John C. Hoefs, Medicine, University of California, Irvine
Background: Shear Wave Elasticity (SWE) by ultrasound
(US) is thought to be similar to Fibroscan in the ability to
Detect cirrhosis and predict Metavir Fibrosis (F0-F4) where
F4 is cirrhosis (Rad 276:845). Neither method of estimating
Cirrhosis measures the functional mass of the liver or
Quantitative liver function. SWE has recently become a
Routine measurement during HCC surveillance. We assess
The ability of SWE to detect cirrhosis. HYPOTHESIS: SWE
Correlate with the presence of cirrhosis. Methods: Our initial
193 patients with SWE at US were reviewed for comparison
With other clinical factors. Non-cirrhotic patients (NC) included
147 with underlying pre-cirrhotic CLD (HBV, HCV, PBC, PSC,
ACAH and miscellaneous), non-cirrhotic portal hypertension
And acute liver disease with jaundice. Cirrhotic patients (C)
Included with never having clinical complications (such as
Ascites, VB and encephalopathy) (C1=16 patients);
with complications in past, but resolved (C2=17); active
complications requiring treatment (C3=10) and those on
the liver transplant list (C4=3). All patients had a fasting US
(GE LOGIQ E9) with SWE per manufactures instructions:
shear wave velocity (SWV) and estimated METAVIR fibrosis
score (eMFS: 0-4) were recorded. Surface nodularity, spleen
length (SL) (cm) and ascites were recorded. Clinical data was
abstracted from the records. Results: SWE was attempted
in 193, but unable in 6 (3%) (NC 3, C 3). The other 187 were
included in this analysis. 144 NC were compared with 43 C:
nodularity: NC 2/144: C1 8/15; C2 14/15; C3 8/10 and C4
2/3. SL>12 CM: NC 10/144; C1 9/15; C2 6/15; C3 9/10; C4
3/3). Ascites: NC 2/144, C1 0/15; C2 2/15; C3 6/10; C4 3/3.
SWV> 1.8: NC 10/144; C1 6/15; C2 7/15; C3 6/10; C4 0/3.
eMFS > 2:NC 12/144; C1 8/15; C2 8/15; C3 7/10; C4 0/3.
76.7 % patients with C were < F4. Of the 10 NC with > F2, 3
had severe acute liver disease with jaundice and 2 had fatty
liver. The percent of patients with C in each eMFS score was
calculated and a good correlation was found with eMFS and
% with Cirrhosis (r2=.978) (figure). However, all 3 patients on
the liver transplant list (C4) had ascites and had an eMFS <3.
Conclusion: eMFS by SWE was unreliable in detecting C
with eMFS (range from 0-4), 2. eMFS F4 had a high percent
with cirrhosis, but most C had < F4, 3. NC Could have a high
eMFS usually associated with severe acute disease. 4. A
nodular liver surface correlated with the presence of cirrhosis.

StephenW

1067
剪切波弹性（SWE）不可靠
检测肝硬化
John C. Hoefs，加州大学欧文分校医学系
背景：超声波剪切波弹性（SWE）
（US）被认为与Fibroscan的能力类似
检测肝硬化并预测Metavir纤维化（F0-F4）在哪里
F4是肝硬化（Rad 276：845）。两种估算方法都没有
肝硬化测量肝脏或肝脏的功能质量
定量肝功能。 SWE最近成为了一名
HCC监测期间的常规测量。我们评估
SWE检测肝硬化的能力。假设：SWE
与肝硬化的存在相关。方法：我们的初步
对193名美国SWE患者进行了回顾性比较
与其他临床因素有关。包括非肝硬化患者（NC）
147与潜在的肝硬化前CLD（HBV，HCV，PBC，PSC，
ACAH及杂项），非肝硬化门静脉高压症
和黄疸急性肝病。肝硬化患者（C）
包括从未有过临床并发症（如
腹水，VB和脑病）（C1 = 16例患者）;
过去有并发症，但已解决（C2 = 17）;活性
需要治疗的并发症（C3 = 10）和那些
肝移植名单（C4 = 3）。所有患者都禁食美国
（GE LOGIQ E9）根据SWE制造商的说明：
剪切波速（SWV）和估计的METAVIR纤维化
记录得分（eMFS：0-4）。表面结节，脾脏
记录长度（SL）（cm）和腹水。临床数据是
从记录中抽象出来。结果：尝试了SWE
在193，但无法在6（3％）（NC 3，C 3）。其他187人
包含在此分析中。将144 NC与43 C进行比较：
结节：NC 2/144：C1 8/15; C2 14/15; C3 8/10和C4
2/3。 SL> 12 CM：NC 10/144; C1 9/15; C2 6/15; C3 9/10; C4
3/3）。腹水：NC 2/144，C1 0/15; C2 2/15; C3 6/10; C4 3/3。
SWV> 1.8：NC 10/144; C1 6/15; C2 7/15; C3 6/10; C4 0/3。
eMFS> 2：NC 12/144; C1 8/15; C2 8/15; C3 7/10; C4 0/3。
76.7％的C患者<F4。在10个NC中，> F2，3
患有严重的急性肝病伴黄疸，2人患有脂肪
肝。每个eMFS评分中C患者的百分比是
计算并发现与eMFS和
肝硬化患者（r2 = .978）（图）。然而，所有3名患者
肝移植名单（C4）有腹水并且eMFS <3。
结论：SWE的eMFS在检测C方面不可靠
使用eMFS（范围从0到4），2。eMFS F4的百分比很高
与肝硬化，但大多数C有<F4,3。NC可能有高
eMFS通常与严重急性疾病有关。 4. A
结节性肝脏表面与肝硬化的存在相关。