使用瞬态弹性成像作为参考的剪切波技术（点剪切波弹性成

StephenW

使用瞬态弹性成像作为参考的剪切波技术（点剪切波弹性成像和二维剪切波弹性成像）的一致性和准确性

费尔南德斯，弗拉维亚； Piedade，朱莉安娜，b；弗雷塔斯，加布里埃尔布；地区，菲利普；桑托斯，里卡多布；格林斯泰因，比阿特丽兹； Veloso，瓦尔迪莱布；佩雷拉，古斯塔沃亚，c；佩拉佐，雨果布
作者信息

a Bonsucesso 联邦医院胃肠病学和肝病科

bOswaldo Cruz 基金会 (FIOCRUZ)、国家传染病研究所 Evandro Chagas (INI)、性病/艾滋病临床研究实验室 (LAPCLIN-AIDS)

c巴西里约热内卢 Estácio de Sá 大学医学院

2022 年 2 月 13 日收到 2022 年 5 月 7 日接受

致 Flavia Ferreira Fernandes, MD, PhD, Bonsucesso Federal Hospital, Av Londres 616, Bonsucesso, Rio de Janeiro, RJ, 医学博士，电话：+552139779893；电子邮件： [email protected]
欧洲胃肠病学和肝病学杂志：2022 年 8 月 - 第 34 卷 - 第 8 期 - 第 873-881 页
doi: 10.1097/MEG.0000000000002400

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抽象的
客观的

我们旨在使用瞬时弹性成像 (TE) 作为参考，评估点剪切波弹性成像 (p-SWE) 和二维剪切波弹性成像 (2D-SWE) 对肝纤维化分期的一致性/准确性。
方法

这项回顾性研究分析了提交给 TE、p-SWE 和 2D-​​SWE 的慢性肝病患者的数据。使用 TE 的“五规则”定义肝纤维化阶段：正常（<5 kPa）；提示代偿期晚期慢性肝病 (cACLD) (10–15 kPa)；高度提示 cACLD (15–20 kPa)；提示有临床意义的门静脉高压症（>20 kPa）。评估了 p-SWE 和 2D-​​SWE 的一致性和准确性。使用最接近 ROC 曲线左上角的点确定 p-SWE 和 2D-​​SWE 的最佳截止值。
结果

共有289名参与者被包括在内。 TE 与 2D-SWE (rho = 0.59; P < 0.001) 或 p-SWE (rho = 0.69; P < 0.001) 之间的相关性令人满意。 TE ≥ 5 kPa 的 2D-SWE 和 p-SWE 的 AUROCs (95% CI)； TE≥10kPa； TE ≥ 15 kPa 和 TE ≥ 20 kPa 分别为 0.757 (0.685–0.829) 和 0.741 (0.676–0.806)； 0.819 (0.770–0.868) 和 0.870 (0.825–0.915)； 0.848 (0.803–0.893) 和 0.952 (0.927–0.978)；分别为 0.851 (0.806–0.896) 和 0.951 (0.920–0.982)。与 p-SWE 相比，2D-SWE 的 AUROC 在检测 cACLD 方面显着降低。 TE ≥ 15 kPa 的 2D-SWE 和 p-SWE 的最佳阈值分别为 8.82 kPa（灵敏度 = 86% 和特异性 = 79%）和 8.86 kPa（灵敏度 = 90% 和特异性 = 92%）。
结论

p-SWE 和 2D-​​SWE 技术的 LSM 与 TE 相关。 p-SWE 的 LSM 似乎比 2D-SWE 更准确地识别患有更晚期纤维化的患者。
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StephenW

Agreement and accuracy of shear-wave techniques (point shear-wave elastography and 2D-shear-wave elastography) using transient elastography as reference

Fernandes, Flaviaa; Piedade, Julianaa,b; Freitas, Gabrielab; Area, Philippea; Santos, Ricardob; Grinsztejn, Beatrizb; Veloso, Valdileab; Pereira, Gustavoa,c; Perazzo, Hugob
Author Information

aDepartment of Gastroenterology and Hepatology, Bonsucesso Federal Hospital

bOswaldo Cruz Foundation (FIOCRUZ), National Institute of Infectious Diseases Evandro Chagas (INI), Laboratory of Clinical Research in STD/AIDS (LAPCLIN-AIDS)

cSchool of Medicine, Estácio de Sá University, Rio de Janeiro, Brazil

Received 13 February 2022 Accepted 7 May 2022

Correspondence to Flavia Ferreira Fernandes, MD, PhD, Department of Gastroenterology and Hepatology, Bonsucesso Federal Hospital, Av Londres 616, Bonsucesso, Rio de Janeiro, RJ, Brazil, Tel: +552139779893; e-mail: [email protected]
European Journal of Gastroenterology & Hepatology: August 2022 - Volume 34 - Issue 8 - p 873-881
doi: 10.1097/MEG.0000000000002400

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Abstract
Objective

We aimed to evaluate the agreement/accuracy of point shear-wave elastography (p-SWE) and 2D-shear-wave elastography (2D-SWE) for liver fibrosis staging using transient elastography (TE) as the reference.
Methods

This retrospective study analyzed data from people with chronic liver diseases submitted to TE, p-SWE, and 2D-SWE. Liver fibrosis stages were defined using the TE’s ‘rule of five’: normal (<5 kPa); suggestive of compensated-advanced chronic liver disease (cACLD) (10–15 kPa); highly suggestive of cACLD (15–20 kPa); suggestive of clinically significant portal hypertension (>20 kPa). Agreement and accuracy of p-SWE and 2D-SWE were assessed. Optimal cutoffs for p-SWE and 2D-SWE were identified using the point nearest to the upper left corner of the ROC curves.
Results

A total of 289 participants were included. The correlation between TE and 2D-SWE (rho = 0.59; P < 0.001) or p-SWE (rho = 0.69; P < 0.001) was satisfactory. The AUROCs (95% CI) of 2D-SWE and p-SWE for TE ≥ 5 kPa; TE ≥ 10 kPa; TE ≥ 15 kPa and TE ≥ 20 kPa were 0.757 (0.685–0.829) and 0.741 (0.676–0.806); 0.819 (0.770–0.868) and 0.870 (0.825–0.915); 0.848 (0.803–0.893) and 0.952 (0.927–0.978); 0.851 (0.806–0.896) and 0.951 (0.920–0.982), respectively. AUROCs of 2D-SWE were significantly lower compared with p-SWE for detecting cACLD. Optimal thresholds of 2D-SWE and p-SWE for TE ≥ 15 kPa were 8.82 kPa (sensitivity = 86% and specificity = 79%) and 8.86 kPa (sensitivity = 90% and specificity = 92%), respectively.
Conclusion

LSM by p-SWE and 2D-SWE techniques were correlated with TE. LSM by p-SWE seems to be more accurate than 2D-SWE to identify patients with more advanced fibrosis.
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