乙型肝炎相关肝硬化门静脉高压症：二维剪切波弹性成像对

StephenW

Hepatol Res. 2018 Dec 29. doi: 10.1111/hepr.13306. [Epub ahead of print]
Portal hypertension in Hepatitis B related Cirrhosis: Diagnostic accuracy of Liver and Spleen stiffness by two-dimensional Shear-wave elastography.
Zhu Y1, Ding H1,2, Fu T1,2, Peng S1, Chen S3, Luo J4, Wang W1.
Author information

1
    Departments of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, 200032, China.
2
    Shanghai Institute of Medical Imaging, Fudan University, Shanghai, 200032, China.
3
    Departments of Gastroenterology, Zhongshan Hospital, Fudan University, Shanghai, 200032, China.
4
    Departments of Interventional Radiology, Zhongshan Hospital, Fudan University, Shanghai, 200032, China.

Abstract
AIM:

To assess the diagnostic accuracy of liver and spleen stiffness measured by two-dimensional shear-wave elastography (2-D SWE) in evaluation of clinically significant and severe portal hypertension (CSPH and SPH).
METHODS:

Clinical data of 155 hepatitis B related cirrhosis patients and their liver and spleen stiffness (L-SWE and S-SWE) were collected. The diagnostic performances of L-SWE, S-SWE, the liver stiffness-spleen-diameter-to-platelet-ratio score (LSPS) and PH risk score were evaluated.
RESULTS:

104 patients were eligible for analysis. CSPH and SPH were detected in 84 and 74 patients respectively. L-SWE and S-SWE were significantly correlated with HVPG in overall, CSPH and SPH groups (rL =0.607, 0.554 and 0.412; rS =0.665, 0.566 and 0.467 respectively; all P<0.05). The AUROCs of L-SWE, S-SWE, LSPS and PH risk score were 0.72 (95%Cl, 0.49-0.95), 0.81 (95%Cl, 0.55-0.97), 0.76 (95%Cl, 0.51-0.96), 0.73 (95%Cl, 0.55-0.88) for CSPH and 0.77 (95%Cl, 0.51-0.93), 0.85 (95%Cl, 0.59-0.96), 0.80 (95%Cl, 0.58-0.98), 0.80 (95%Cl, 0.59-0.93) for SPH. The best cut-off of L-SWE for determining CSPH and SPH were 16.1 kPa (Sensitivity, 78%; Specificity, 72%) and 23.5 kPa (Sensitivity, 81%; Specificity, 79%). For S-SWE, the best cut-offs were 25.3 kPa (Sensitivity, 85%; Specificity, 79%) and 33.4 kPa (Sensitivity, 74%; Specificity, 70%). A cut-off of L-SWE < 13.2 kPa or S-SWE < 23.2 kPa was able to rule-out CSPH while a cut-off of L-SWE > 24.9 kPa or S-SWE > 34.2 kPa was able to rule-in CSPH.
CONCLUSIONS:

liver and spleen stiffness measured by 2-D SWE are reliable and promising non-invasive parameters to assess CSPH and SPH.

This article is protected by copyright. All rights reserved.
KEYWORDS:

clinically significant portal hypertension; hepatic vein pressure gradient; severe portal hypertension; shear-wave elastography; stiffness

PMID:
    30597744
DOI:
    10.1111/hepr.13306

StephenW

Hepatol Res。 2018年12月29日doi：10.1111 / hepr.13306。 [提前打印]
乙型肝炎相关肝硬化门静脉高压症：二维剪切波弹性成像对肝脏和脾脏硬度的诊断准确性。
朱Y1，丁H1,2，傅T1,2，彭S1，陈S3，罗J4，王W1。
作者信息

1
    复旦大学附属中山医院超声科，上海200032
2
    复旦大学上海医学影像研究所，上海200032
3
    复旦大学附属中山医院消化内科，上海200032
4
    复旦大学附属中山医院介入放射科，上海200032

抽象
目标：

评估二维剪切波弹性成像（2-D SWE）测量的肝脏和脾脏硬度的诊断准确性，评估临床显着和严重的门静脉高压症（CSPH和SPH）。
方法：

收集155例乙型肝炎相关肝硬化患者及其肝脾硬度（L-SWE和S-SWE）的临床资料。评估L-SWE，S-SWE，肝硬度 - 脾 - 直径 - 血小板比值（LSPS）和PH风险评分的诊断性能。
结果：

104名患者符合分析条件。分别在84例和74例患者中检测到CSPH和SPH。 L-SWE和S-SWE与整体，CSPH和SPH组的HVPG显着相关（rL = 0.607,0.554和0.412; rS = 0.665,0.566和0.467;所有P <0.05）。 L-SWE，S-SWE，LSPS和PH风险评分的AUROC分别为0.72（95％Cl，0.49-0.95），0.81（95％Cl，0.55-0.97），0.76（95％Cl，0.51-0.96）， C73H为0.73（95％Cl，0.55-0.88），0.77（95％Cl，0.51-0.93），0.85（95％Cl，0.59-0.96），0.80（95％Cl，0.58-0.98），0.80（95％） Cl，0.59-0.93）用于SPH。用于测定CSPH和SPH的L-SWE的最佳截止值是16.1kPa（灵敏度，78％;特异性，72％）和23.5kPa（灵敏度，81％;特异性，79％）。对于S-SWE，最佳截止值为25.3kPa（灵敏度，85％;特异性，79％）和33.4kPa（灵敏度，74％;特异性，70％）。 L-SWE <13.2 kPa或S-SWE <23.2 kPa的截止值能够排除CSPH，而L-SWE> 24.9 kPa或S-SWE> 34.2 kPa的截止值能够排除部CSPH。
结论：

通过2-D SWE测量的肝脏和脾脏硬度是评估CSPH和SPH的可靠且有前景的非侵入性参数。

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关键词：

临床上显着的门静脉高压;肝静脉压力梯度;严重门静脉高压;剪切波弹性成像;刚性

结论：
    30597744
DOI：