Non-invasive evaluation of liver fibrosis: a comparison of ultrasound-based transient elastography and MR elastography in patients with viral hepatitis B and C

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• 作者：Anneloes E. Bohte (1) (9)
  Annikki de Niet (2)
  Louis Jansen (2)
  Shandra Bipat (1)
  Aart J. Nederveen (1)
  Joanne Verheij (3)
  Valeska Terpstra (4)
  Ralph Sinkus (5)
  Karin M. J. van Nieuwkerk (6)
  Rob J. de Knegt (7)
  Bert C. Baak (8)
  Peter L. M. Jansen (2)
  Henk W. Reesink (2)
  Jaap Stoker (1)
  
• 关键词：Elasticity imaging techniques ; Hepatitis C ; Hepatitis B ; Sensitivity and specificity
• 刊名：European Radiology
• 出版年：2014
• 出版时间：March 2014
• 年：2014
• 卷：24
• 期：3
• 页码：638-648
• 全文大小：393 KB
• 作者单位：Anneloes E. Bohte (1) (9)
  Annikki de Niet (2)
  Louis Jansen (2)
  Shandra Bipat (1)
  Aart J. Nederveen (1)
  Joanne Verheij (3)
  Valeska Terpstra (4)
  Ralph Sinkus (5)
  Karin M. J. van Nieuwkerk (6)
  Rob J. de Knegt (7)
  Bert C. Baak (8)
  Peter L. M. Jansen (2)
  Henk W. Reesink (2)
  Jaap Stoker (1)
  
  1. Department of Radiology, Academic Medical Center, Amsterdam, The Netherlands
  9. Academic Medical Center Amsterdam, Meibergdreef 9, 1105AZ, Amsterdam, The Netherlands
  2. Department of Gastroenterology and Hepatology, Academic Medical Center, Amsterdam, The Netherlands
  3. Department of Pathology, Academic Medical Center, Amsterdam, The Netherlands
  4. Department of Pathology, Bronovo Hospital, The Hague, The Netherlands
  5. Department of Radiology and IPMA, INSERM UMR 773, Beaujon University Hospital, University of Paris Diderot, Clichy, France
  6. Department of Gastroenterology and Hepatology, Free University Medical Center, Amsterdam, The Netherlands
  7. Department of Gastroenterology and Hepatology, Erasmus University Medical Center, Rotterdam, The Netherlands
  8. Department of Gastroenterology and Hepatology, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands
  
• ISSN：1432-1084

文摘

Objective To compare the diagnostic accuracy of TE and MRE and establish cutoff levels and diagnostic strategies for both techniques, enabling selection of patients for liver biopsy. Methods One hundred three patients with chronic hepatitis B or C and liver biopsy were prospectively included. Areas under curves (AUROC) were compared for TE and MRE for METAVIR fibrosis grade?≥?F2 and ≥F3. We defined cutoff values for selection of patients with F0–F1 (sensitivity >95?%) and for significant fibrosis F2–F4 (specificity >95?%). Results Following exclusions, 85 patients were analysed (65 CHB, 19 CHC, 1 co-infected). Fibrosis stages were F0 (n--), F1 (n--3), F2 (n--5), F3 (n--) and F4 (n--). TE and MRE accuracy were comparable [AUROCTE?≥?F2: 0.914 (95?% CI: 0.857-.972) vs. AUROCMRE?≥?F2: 0.909 (0.840-.977), P--.89; AUROCTE?≥?F3: 0.895 (0.816-.974) vs. AUROCMRE?≥?F3: 0.928 (0.874-.982), P--.42]. Cutoff values of <5.2 and ?.9?kPa (TE) and <1.66 and ?.18?kPa (MRE) diagnosed 64?% and 66?% of patients correctly as F0–F1 or F2–F4. A conditional strategy in inconclusive test results increased diagnostic yield to 80?%. Conclusion TE and MRE have comparable accuracy for detecting significant fibrosis, which was reliably detected or excluded in two-thirds of patients. A conditional strategy further increased diagnostic yield to 80?%. Key Points -Both ultrasound-based transient elastography and magnetic resonance elastography can assess hepatic fibrosis. -Both have comparable accuracy for detecting liver fibrosis in viral hepatitis. -The individual techniques reliably detect or exclude significant liver fibrosis in 66?%. -A conditional strategy for inconclusive findings increases the number of correct diagnoses.