慢性乙型肝炎肝癌患者术前无创性肝纤维化评估：二维剪切

StephenW

Eur J Radiol

. 2020 Nov 2;133:109386.
doi: 10.1016/j.ejrad.2020.109386. Online ahead of print.
Preoperative noninvasive assessment for liver fibrosis in hepatocellular carcinoma patients with chronic hepatitis B: Comparison of two-dimensional shear-wave elastography with serum liver fibrosis models
Shuochun Chen  1 , Tian'an Jiang  2
Affiliations
Affiliations

    1
    Department of Ultrasound, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China. Electronic address: [email protected].
    2
    Department of Ultrasound, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China. Electronic address: [email protected].

    PMID: 33160197 DOI: 10.1016/j.ejrad.2020.109386

Abstract

Purpose: To investigate the diagnostic performance of two-dimensional shear-wave elastography (2D-SWE) in hepatocellular carcinoma patients with chronic hepatitis B adapted to hepatectomy comparing to serum liver fibrosis models.

Method: 100 patients with chronic hepatitis B who first diagnosed with hepatocellular carcinoma and had undergone 2D-SWE measurements before the hepatectomy were included. The performance of 2D-SWE and serum models in the diagnosis of liver fibrosis was assessed using receiver operating characteristic (ROC) analyses.

Results: The areas under ROC (AUCs) for 2D-SWE, Forns score, aspartate transaminase-to-platelet ratio index (APRI) and Fibrosis 4 Score (FIB-4) were 0.983, 0.757, 0.745, 0.710 in the diagnosis of significant fibrosis (F ≥ 2) respectively, and 0.896, 0.718, 0.626, 0.575 in the diagnosis of cirrhosis (F = 4) respectively. The AUCs for 2D-SWE in the diagnosis of significant fibrosis and cirrhosis were significantly higher than those for the serum fibrosis models (p < 0.05). The AUCs of Forns in the diagnosis of significant fibrosis (F ≥ 2) showed no statistical differences (p > 0.05) with those of APRI and FIB-4 while in the diagnosis of cirrhosis (F = 4), they are significantly higher (p < 0.05).

Conclusions: 2D-SWE is a reliable method for preoperative noninvasive assessment of liver fibrosis in HCC patients with CHB, with notably higher diagnostic accuracy than serum liver fibrosis models.

Keywords: Chronic hepatitis B; Hepatocellular carcinoma; Liver fibrosis; Serum liver fibrosis model; Two-dimensional shear-wave elastography.

Copyright © 2020 The Author(s). Published by Elsevier B.V. All rights reserved.

StephenW

Eur J Radiol

。 2020年11月2日； 133：109386。
doi：10.1016 / j.ejrad.2020.109386。在线印刷。
慢性乙型肝炎肝癌患者术前无创性肝纤维化评估：二维剪切波弹性成像与血清肝纤维化模型的比较
陈硕春1江天安2
隶属关系
隶属关系

    1个
    浙江大学医学院附属第一医院超声科，浙江杭州电子地址：[email protected]。
    2
    浙江大学医学院附属第一医院超声科，浙江杭州电子地址：[email protected]。

    PMID：33160197 DOI：10.1016 / j.ejrad.2020.109386

抽象

目的：比较血清肝纤维化模型，探讨二维剪切波弹性成像技术（2D-SWE）在慢性乙型肝炎肝癌适合肝切除术中的诊断价值。

方法：纳入100例首先诊断为肝细胞癌并在肝切除术前进行了二维SWE测量的慢性乙型肝炎患者。使用接收器操作特征（ROC）分析评估了2D-SWE和血清模型在肝纤维化诊断中的性能。

结果：2D-SWE，Forns得分，天冬氨酸转氨酶与血小板比率指数（APRI）和纤维化4得分（FIB-4）的ROC（AUCs）区域分别为0.983、0.757、0.745、0.710纤维化（F≥2），分别为0.896、0.718、0.626、0.575，用于肝硬化的诊断（F = 4）。用于诊断严重纤维化和肝硬化的2D-SWE的AUC显着高于血清纤维化模型的AUC（p <0.05）。 Forns的AUC在诊断为严重纤维化（F≥2）时与APRI和FIB-4相比无统计学差异（p> 0.05），而在肝硬化的诊断（F = 4）中，它们的AUC显着更高（p <0.05）。

结论：2D-SWE是一种可靠的方法，可用于术前无创性评估CHC肝癌患者的肝纤维化，其诊断准确性明显高于血清肝纤维化模型。

关键字：慢性乙型肝炎；肝细胞癌；肝纤维化；血清肝纤维化模型；二维剪切波弹性成像。

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