Diagnosis of liver fibrosis and cirrhosis using liver stiffness measurement: Comparison between M and XL probe of FibroScan庐

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• 作者：Victor de L&eacute ; dinghen¹ ; ² ; ^{victor.deledinghen@chu-bordeaux.fr} ; Vincent Wai-Sun Wong³ ; ⁴ ; Julien Vergniol¹ ; Grace Lai-Hung Wong³ ; ⁴ ; Juliette Foucher¹ ; Shirley Ho-Ting Chu³ ; ⁴ ; Brigitte Le Bail² ; ⁵ ; Paul Cheung-Lung Choi⁶ ; Faiza Chermak¹ ; Karen Kar-Lum Yiu³ ; ⁴ ; Wassil Merrouche¹ ; Henry Lik-Yuen Chan³ ; ⁴
• 关键词：ALT ; alanine aminotransferase ; APRI ; AST-to-platelet ratio index ; AST ; aspartate aminotransferase ; AUROC ; area under the receiver-operating characteristics curve ; CI ; confidence interval ; IQR ; interquartile range ; LR ; likelihood ratio ; LSM ; liver stiffnes
• 刊名：Journal of Hepatology
• 出版年：2012
• 期刊代码：162_01688278
• 类别：med
• 出版时间：April, 2012
• 卷：56
• 期：4
• 页码：833-839
• 文件大小：720 K

摘要

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Background & Aims

Unreliable results of liver stiffness measurement are obtained in 16%of cases and are independently associated with body mass index (BMI) greater than 30 kg/m². A new FibroScan庐 probe (XL probe) was designed specifically for obese patients. The aim of this study was to evaluate the accuracy of liver stiffness measurement using M and XL probes of Fibroscan庐 for the diagnosis of fibrosis and cirrhosis in a large cohort of patients.

Methods

Consecutive patients undergoing liver biopsies for chronic liver disease were prospectively recruited. Liver stiffness measurement was performed within 1 week before liver biopsy using both M and XL probes of FibroScan庐.

Results

A total of 286 patients were evaluated. A reliable liver stiffness measurement using M probe was obtained in 79.7%of cases. In the other 21.3%, liver stiffness measurement using XL probe was obtained in 56.9%of patients. A strong correlation was found between M and XL values, regardless of BMI. In all groups, median liver stiffness measurement using the XL probe was significantly lower than liver stiffness measurement using the M probe. By multivariate analysis, unsuccessful liver stiffness examination with M probe was independently associated with age >50 years and BMI >30 kg/m². By univariate analysis, only BMI >30 kg/m² was associated with unsuccessful liver stiffness measurement with XL probe. No significant difference was observed between the M and XL probes for the diagnosis of liver fibrosis.

Conclusions

Liver stiffness measurement with either M or XL probe is possible in 91.2%of patients with comparable diagnostic accuracy. In clinical practice, the M probe could be used as first step for liver stiffness measurement. In case of no valid shot or unreliable measurement, the XL probe could be used. This result could be useful for the assessment of liver fibrosis in NAFLD and/or obese patients.