二维剪切波弹性成像用于 HBV 相关代偿期晚期慢性肝病患者的

StephenW

二维剪切波弹性成像用于 HBV 相关代偿期晚期慢性肝病患者的内镜筛查
闫玉玲
, 咸兴
, 陆强
, 王小泽
, 罗雪峰
&李扬
2021 年 7 月 26 日接收，2021 年 12 月 16 日接受，接受的作者版本在线发布：2021 年 12 月 23 日，在线发布：2022 年 1 月 11 日

    下载引文 https://doi.org/10.1080/17474124.2022.2020644 CrossMark Logo CrossMark

抽象的
目标

研究 2D-SWE 测量的肝硬度 (LS) 对乙型肝炎病毒 (HBV) 相关代偿期晚期慢性肝病 (cACLD) 患者食管静脉曲张 (EV) 和高危静脉曲张 (HRV) 的诊断性能.
方法

总共对 268 名接受 2D-SWE 和食管胃十二指肠镜 (EGD) 的 HBV 相关 cACLD 患者进行了回顾性评估。排除 HRV 的新标准在 175 名患者的训练队列中进行了测试，并在 93 名患者的验证队列中进行了验证。
结果

LS 预测 EV 和 HRV 的 AUROC 分别为 0.90（0.86-0.95）和 0.93（0.89-0.96）。 LS (OR, 1.64 (95% CI: 1.31–2.07); P < 0.0001), PLT (OR, 0.94 (95% CI: 0.91–0.97); P < 0.0001) 和白蛋白 (OR, 0.75 (95% CI: 0.62–0.90)；P = 0.02) 是 HRV 存在的独立因素。 LS < 20 kPa 和 PLT > 150 × 109 /L 的 Baveno VI 标准节省了 15.1%–17.1% EGD 筛查和 0–4.3% HRV 漏诊率。 LS < 16 kPa 和 PLT > 60 × 109 /L 可避免 51.4%–52.7% 的 EGD 筛查，HRV 漏诊率为 3.8%–4.3%。
结论

Baveno VI 标准适用于 2D-SWE 以排除 HRV。 LS < 16 kPa 和 PLT > 60 × 109 /L 可能是排除 HBV 相关 cACLD 患者 HRV 的可靠模型。

关键词：高危静脉曲张食管静脉曲张二维剪切波弹性成像超声肝硬度

StephenW

Two-dimensional shear wave elastography for sparing endoscopy screening in patients with HBV-related compensated advanced chronic liver disease
Yuling Yan
, Xian Xing
, Qiang Lu
, Xiaoze Wang
, Xuefeng Luo
& Li Yang
Received 26 Jul 2021, Accepted 16 Dec 2021, Accepted author version posted online: 23 Dec 2021, Published online: 11 Jan 2022

    Download citation https://doi.org/10.1080/17474124.2022.2020644 CrossMark Logo CrossMark

ABSTRACT
Objectives

To investigate the diagnostic performance of liver stiffness (LS) measured by 2D-SWE for predicting esophageal varices (EV) and high-risk varices (HRV) in patients with hepatitis B virus (HBV)-related compensated advanced chronic liver disease (cACLD).
Methods

In total, 268 patients with HBV-related cACLD who underwent 2D-SWE and esophagogastroduodenoscopy (EGD) were retrospectively evaluated. The new criteria for ruling out HRV were tested in the training cohort with 175 patients and validated in the validation cohort with 93 patients.
Results

The AUROCs of LS for predicting EV and HRV were 0.90(0.86–0.95) and 0.93(0.89–0.96) respectively. LS (OR, 1.64 (95% CI: 1.31–2.07); P < 0.0001), PLT (OR, 0.94 (95% CI: 0.91–0.97); P < 0.0001) and albumin (OR, 0.75 (95% CI: 0.62–0.90); P = 0.02) were independent factors for the presence of HRV. The Baveno VI criteria of LS < 20 kPa and PLT > 150 × 109 /L saved 15.1%–17.1% EGD screening with 0–4.3% HRV miss rate. LS < 16 kPa and PLT > 60 × 109 /L spared 51.4%–52.7% EGD screening with 3.8%–4.3% HRV miss rate.
Conclusion

Baveno VI criteria is suitable for 2D-SWE to rule out HRV. LS < 16 kPa and PLT > 60 × 109 /L could be a reliable model for ruling out HRV in patients with HBV-related cACLD.

KEYWORDS: High-risk varicesesophageal varicesTwo-dimensional shear wave elastographyultrasoundliver stiffness