Liver fibrosis evaluation using real-time shear wave elastography: Applicability and diagnostic performance using methods without a gold standard

详细信息    查看全文

• 作者：Thierry Poynard¹ ; ^{tpoynard@teaser.fr} ; Mona Munteanu² ; Elena Luckina¹ ; ³ ; Hugo Perazzo¹ ; Yen Ngo¹ ; Luca Royer¹ ; Larysa Fedchuk¹ ; Florence Sattonnet¹ ; Raluca Pais¹ ; Pascal Lebray¹ ; Marika Rudler¹ ; Dominique Thabut¹ ; Vlad Ratziu¹
• 关键词：Fibrosis ; Obuchowski measure ; Concordance ; FibroTest ; FibroSure ; FibroScan ; Aixplorer ; Non-invasive methods
• 刊名：Journal of Hepatology
• 出版年：2013
• 出版时间：May, 2013
• 年：2013
• 卷：58
• 期：5
• 页码：928-935
• 全文大小：606 K

文摘

| Figures/TablesFigures/Tables | ReferencesReferences

Background & Aims

Real-time shear wave elastography (SWE) is a new two-dimensional transient elastography which had no assessment of factors associated with reliability, and had limited comparisons with other validated fibrosis biomarkers. The aim was to assess the applicability and performances of SWE for the diagnosis of fibrosis as compared with FibroTest (FT) and liver stiffness measurement (LSM) by transient elastography using two probes (TE-M and TE-XL).

Methods

Without a gold standard, the strength of concordance, discordance analysis and latent class analysis (LCM) were applied.

Results

422 patients were included. The applicability of SWE (90.0 % ) was significantly lower than that of FT (97.9 % ; p <0.0001) and did not differ from those of TE-M (90.5 % ) and TE-XL (90.3 % ); it was higher though for SWE (86 % ) in 22 patients with ascites vs. 55 % using TE-M (p = 0.04). For the diagnosis of all fibrosis stages as presumed by FT, the performance of SWE was highly significant (Obuchowski measure 0.807 ¡À 0.013 [m ¡À se]), but lower than those of TE-M (0.852; p = 0.0007) and TE-XL (0.834; p = 0.046). SWE had a low performance for discrimination between F0 and F1. For the diagnosis of cirrhosis using LCM, SWE specificities were all equal to 99 % , and SWE sensitivities ranged from 0.47 to 0.64. For the diagnosis of non-cirrhotic stages, the results were heterogeneous.

Conclusions

The performance of SWE for the diagnosis of cirrhosis was similar to those of FT and TE. SWE applicability was lower than that of FT, but greater than that of TE in patients with ascites.