Liver Fibrosis with Two-dimensional US Shear-Wave Elastography in Participants with Chronic Hepatitis B: A Prospective Multicenter Study

被引：73

作者：

Gao, Yongyan ^{[1
,2
]}

Zheng, Jian ^{[3
,4
]}

Liang, Ping ^{[1
]}

Tong, Minghui ^{[5
]}

Wang, Jiabing ^{[5
]}

Wu, Changjun ^{[6
]}

He, Xin ^{[6
]}

Lin, Changzhu ^{[7
]}

Zhang, Shumei ^{[7
]}

Huang, Liping ^{[8
]}

Jiang, Tian'an ^{[9
]}

Cheng, Chao ^{[9
]}

Meng, Fankun ^{[10
]}

Mu, Xiaojie ^{[10
]}

Lu, Yongping ^{[11
]}

Li, Yanyan ^{[11
]}

Ai, Hong ^{[12
]}

Qiao, Xudong ^{[12
]}

Xie, Xiao-Yan ^{[13
]}

Wang, Wei ^{[13
]}

Yin, Li-ping ^{[14
]}

Wu, Yi-yun ^{[14
]}

Zheng, Rongqin ^{[3
]}

机构：

[1] Chinese Peoples Liberat Army Gen Hosp, Dept Intervent Ultrasound, 28 Fuxing Rd, Beijing 100853, Peoples R China

[2] Gen Hosp Chinese Peoples Armed Police Forces, Dept Ultrasound, Beijing, Peoples R China

[3] Sun Yat Sen Univ, Affiliated Hosp 3, Dept Ultrasound, Guangdong Key Lab Liver Dis Res, Guangzhou, Guangdong, Peoples R China

[4] Third Peoples Hosp Longgang Dist Shenzhen, Dept Ultrasound, Shenzhen, Peoples R China

[5] Lanzhou Univ, Hosp 2, Childrens Hosp, Funct Examinat Dept, Lanzhou, Gansu, Peoples R China

[6] Harbin Med Univ, Affiliated Hosp 1, Ultrasound Dept, Harbin, Heilongjiang, Peoples R China

[7] Guangzhou Eighth Peoples Hosp, Ultrasound Dept, Guangzhou, Guangdong, Peoples R China

[8] China Med Univ, Shengjing Hosp, Dept Ultrasound, Shenyang, Liaoning, Peoples R China

[9] Zhejiang Univ, Med Coll, Affiliated Hosp 1, Dept Uhrasonog, Hangzhou, Zhejiang, Peoples R China

[10] Capital Med Univ, Beijing Youan Hosp, Funct Diag Ctr, Beijing, Peoples R China

[11] Second Peoples Hosp Yunnan Prov, Ultrasound Dept, Kunming, Yunnan, Peoples R China

[12] Xi An Jiao Tong Univ, Affiliated Hosp 1, Ultrasound Dept, Xian, Shaanxi, Peoples R China

[13] Sun Yat Sen Univ, Affiliated Hosp 1, Inst Diagnost & Intervent Ultrasound, Dept Med Ultrason, Guangzhou, Guangdong, Peoples R China

[14] Nanjing Univ TCM, Affiliated Hosp, Jiangsu Prov Hosp TCM, Dept Ultrasound, Nanjing, Jiangsu, Peoples R China

来源：

RADIOLOGY | 2018年 / 289卷 / 02期

关键词：

SIMPLE NONINVASIVE INDEX; TRANSIENT ELASTOGRAPHY; DIAGNOSTIC PERFORMANCE; RELIABILITY CRITERIA; STIFFNESS; ACCURACY; CIRRHOSIS; DISEASE; PREDICT; BIOPSY;

D O I：

10.1148/radiol.2018172479

中图分类号：

R8 [特种医学]; R445 [影像诊断学];

学科分类号：

1002 ; 100207 ; 1009 ;

摘要：

Purpose: To investigate the diagnostic performance of two-dimensional (2D) shear-wave elastography (SWE) in chronic hepatitis B. Materials and Methods: This prospective multicenter study from January 2015 to January 2016 was conducted at 12 hospitals and included 654 participants with chronic hepatitis B who had undergone liver biopsy and 2D SWE examination. Participants were divided into chronic infection and chronic hepatitis groups. The diagnostic performance of 2D SWE was compared with the aspartate amino transferase-to-platelet ratio index (APRI), the Fibrosis-4 index (FIB-4), and transient elastography (TE) by using a DeLong test and was also compared between two subgroups. Dual cutoff values for cirrhosis were determined with multilevel likelihood ratio analysis. Results: Overall, 402 participants with chronic hepatitis B were enrolled (154 with chronic infection and 248 with chronic hepatitis). The areas under the receiver operating characteristic curve of 2D SWE (0.87; 95% confidence interval [CI]: 0.83, 0.90) were higher than those of TE (0.80; 95% CI: 0.68, 0.88), APRI (0.70; 95% CI: 0.65, 0.74), and FIB-4 (0.73; 95% CI: 0.69, 0.78) in cirrhosis. The high area under the receiver operating characteristic curve (0.92; 95% CI: 0.87, 0.96) was achieved in the chronic infection group and was significantly higher than that of the chronic hepatitis group (0.84; 95% CI: 0.78, 0.88; P = .017). Dual cutoff values with the likelihood ratios below 0.1 and above 10 (8.4 kPa and 11.0 kPa to rule out and rule in a diagnosis of cirrhosis, respectively) were effectively determined in chronic infection; a total of 81.2% (125 of 154) participants with cirrhosis were definitively diagnosed. Conclusion: The performance of two-dimensional (2D) shear-wave elastography (SWE) was higher than that of other noninvasive methods. 2D SWE was most effective in ruling in and ruling out cirrhosis in participants with chronic infection, which may prompt antiviral treatment. (c) RSNA, 2018

引用

页码：407 / 415

页数：9

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