新型剪切波弹性成像技术对慢性乙型肝炎患者肝纤维化无创

StephenW

Usefulness of New Shear Wave Elastography Technique for Noninvasive Assessment of Liver Fibrosis in Patients with Chronic Hepatitis B: A Prospective Multicenter Study
Jinfen Wang #  1 , Manli Wu #  1 , Runze Linghu #  2 , Jiandong Chang  3 , Min Wu  4 , Cheng Feng  5 , Xinping Ren  6 , Changzhu Liu  7 , Jie Lin  8 , Tao Song  9 , Jionghui Gu  10 , Yao Zhang  11 , Ye Fang  12 , Sumei Ma  13 , Pingxiang Hu  14 , Linsong Wu  15 , Xue Han  16 , Kaixuan Chen  17 , Qiusheng Shi  18 , Ruifang Zhang  19 , Qi Zhou  20 , Ruiqing Du  21 , Yongyan Gao  22 , Xiang Jing  23 , Shunshi Yang  24 , Chang Zhou  25 , Jian Zheng  26 , Ping Liang  2 , Rong-Qin Zheng  1
Affiliations

    PMID: 33910257 DOI: 10.1055/a-1376-6734

Abstract in English, German

Purpose: To explore the usefulness of liver stiffness measurements (LSMs) by sound touch elastography (STE) and sound touch quantification (STQ) in chronic hepatitis B (CHB) patients for staging fibrosis.

Methods: This prospective multicenter study recruited normal volunteers and CHB patients between May 2018 and October 2019. The volunteers underwent LSM by STE and supersonic shear imaging (SSI) or by STQ and acoustic radiation force impulse imaging (ARFI). CHB patients underwent liver biopsy and LSM by both STE/STQ. The areas under the receiver operating characteristic curves (AUCs) for staging fibrosis were calculated.

Results: Overall, 97 volunteers and 524 CHB patients were finally eligible for the study. The successful STE and STQ measurement rates were both 100 % in volunteers and 99.4 % in CHB patients. The intraclass correlation coefficients (ICCs) for the intra-observer stability of STE and STQ (0.94; 0.90) were similar to those of SSI and ARFI (0.95; 0.87), respectively. STE and STQ showed better accuracy than the aspartate aminotransferase-to-platelet ratio index (APRI) and fibrosis-4 index (FIB-4) (AUC: 0.87 vs 0.86 vs 0.73 vs 0.77) in staging cirrhosis. However, both STE and STQ were not superior to APRI and FIB-4 in staging significant fibrosis (AUC: 0.76 vs 0.73 vs 0.70 vs 0.71, all P-values > 0.05).

Conclusion: STE and STQ are convenient techniques with a reliable LSM value. They have a similar diagnostic performance and are superior to serum biomarkers in staging cirrhosis in CHB patients.

Thieme. All rights reserved.

StephenW

新型剪切波弹性成像技术对慢性乙型肝炎患者肝纤维化无创评估的实用性：一项前瞻性多中心研究
王金芬1，吴满丽1，润泽令狐2，建东昌3，吴敏4，成峰5，新平人6，刘长竹7，杰琳8，陶颂9，炯辉谷10，张瑶11 ，叶芳12，马苏梅13，胡萍香14，吴林松15，薛寒16，陈凯旋17，秋生石18，张瑞芳19，祁州20，杜瑞青21，高永艳22，向京23，顺始杨24，常州25，监政26，平平2，郑荣勤1
隶属关系

    PMID：33910257 DOI：10.1055 / a-1376-6734

英文，德文摘要

目的：探讨通过声音接触弹性成像（STE）和声音接触定量（STQ）在慢性乙型肝炎（CHB）患者中进行肝硬度测量（LSM）对分期纤维化的有效性。

方法：这项前瞻性多中心研究在2018年5月至2019年10月之间招募了正常志愿者和CHB患者。志愿者通过STE和超声切变成像（SSI）或STQ和声辐射力脉冲成像（ARFI）接受了LSM。 CHB患者均通过STE / STQ进行肝活检和LSM。计算用于分期纤维化的接收器工作特征曲线（AUC）下的面积。

结果：总共有97名志愿者和524名CHB患者最终符合研究条件。成功的STE和STQ测量率在志愿者中均为100％，在CHB患者中为99.4％。 STE和STQ的观察者内部稳定性的类内相关系数（ICC）（0.94; 0.90）分别类似于SSI和ARFI（0.95; 0.87）。在分期性肝硬化中，STE和STQ的准确性优于天冬氨酸氨基转移酶与血小板的比率指数（APRI）和纤维化4指数（FIB-4）（AUC：0.87 vs 0.86 vs 0.73 vs 0.77）。然而，在分期显着纤维化方面，STE和STQ均不优于APRI和FIB-4（AUC：0.76 vs 0.73 vs 0.70 vs 0.71，所有P值均大于0.05）。

结论：STE和STQ是具有可靠LSM值的便捷技术。它们在CHB患者的肝硬化分期中具有相似的诊断性能，并且优于血清生物标志物