中文English
ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Issue 11
Nov.  2018
Turn off MathJax
Article Contents

Diagnostic efficacy of shear wave elastography in evaluating chronic hepatitis B liver fibrosis and related influencing factors

DOI: 10.3969/j.issn.1001-5256.2018.11.012
Research funding:

 

  • Published Date: 2018-11-20
  • Objective To investigate the diagnostic efficiency of shear wave elastography ( SWE) in evaluating chronic hepatitis B ( CHB) liver fibrosis and related influencing factors. Methods A total of 147 CHB patients who visited Shengjing Hospital of China Medical University from January 2016 to September 2017 were enrolled. SWE was performed for all patients, and liver biopsy was performed within one week after SWE. General information and serological test results of the patients were collected. The Mann-Whitney U test was used for comparison of non-normally distributed continuous data; the chi-square test was used for comparison of categorical data between groups.The receiver operating characteristic ( ROC) curve was plotted to evaluate diagnostic efficiency, and the logistic regression model was used to determine the factors associated with the accuracy of SWE in assessing liver fibrosis stage. Results With liver fibrosis stage determined by liver histology as the standard, the areas under the ROC curve of SWE in the diagnosis of ≥F1, ≥F2, ≥F3, and ≥F4 liver fibrosis were0. 824, 0. 880, 0. 914, and 0. 986, respectively, with sensitivities of 91. 0%, 91. 7%, 87. 0%, and 88. 9%, respectively and specificities of 66. 0%, 82. 8%, 66. 0%, and 94. 9%, respectively, at the optimal cut-off values of 6. 1 kPa, 7. 0 k Pa, 8. 1 kPa, and 10. 0 k Pa, respectively. The positive predictive values were 85. 0%, 78. 6%, 48. 3%, and 53. 3%, respectively, and the negative predictive values were 77. 5%, 93. 5%, 97. 2%, and 99. 2%, respectively. According to the results of liver biopsy, of all 147 patients, 94 had an accurate diagnosis based on SWE, while 53 had an inaccurate diagnosis; there were significant differences between these two groups in alanine aminotransferase, aspartate aminotransferase, and liver inflammation grade ( Z =-4. 211、-4. 649、-3. 513, all P < 0. 01) . Liver inflammation grade ( odds ratio [OR]= 0. 552, 95% confidence interval [CI]: 0. 317-0. 963, P = 0. 028) was an independent influencing factor for the diagnostic accuracy of SWE, and it had a significant effect on SWE in diagnosing liver fibrosis in the case of stage F0 liver fibrosis ( OR= 1. 809, 95% CI: 2. 305-51. 195) and stage F2 liver fibrosis ( OR = 1. 345, 95% CI: 1. 037-13. 647) . Conclusion Liver stiffness measured by SWE has good diagnostic efficacy in assessing liver fibrosis stage, and the accuracy of liver fibrosis stage assessment is affected by liver inflammation stage.

     

  • loading
  • [1] PELLICORO A, RAMACHANDRAN P, LREDALE JP, et al. Liver fibrosis and repair:Immune regulation of wound healing in a solid organ[J]. Nat Rev Immunol, 2014, 14 (3) :181-194.
    [2] FRIEDMAN SL, BANSAL MB. Reversal of hepatic fibrosis—fact or fantasy?[J]. Hepatology, 2006, 43 (S1) :s82-s88.
    [3] van DER POORTEN D, KWOK A, LAM T, et al. Twenty-year audit of percutaneous liver biopsy in a major Australian teaching hospital[J]. Intern Med J, 2006, 36 (11) :692-699.
    [4] BRAVO AA, SHETH SG, CHOPRA S. Liver biopsy[J]. N Engl J Med, 2001, 344 (7) :495-500.
    [5] BEDOSSA P, DARGERE D, PARADIS V. Sampling variability of liver fibrosis in chronic hepatitis C[J]. Hepatology, 2003, 38 (6) :1449-1457.
    [6] PARK BK, PARK YN, AHN SH, et al. Long-term outcome of chronic hepatitis B based on histological grade and stage[J]. J Gastroenterol Hepatol, 2007, 22 (3) :383-388.
    [7] HAN XY, CHEN XJ, YAN ZQ, et al. Correlation among HBsAg and HBV DNA levels with liver fibrosis in patients with hepatitis B[J]. Int J Virol, 2016, 23 (1) :50-52. (in Chinese) 韩晓颖, 陈秀记, 闫泽强, 等.血清HBsAg与HBV DNA水平与乙肝患者肝纤维化程度的相关性分析[J].国际病毒学杂志, 2016, 23 (1) :50-52.
    [8] NIU M, DENG DY, LIYUN PF, et al. Value of MRE in diagnosis of stages of hepatic fibrosis:A Meta-analysis[J]. J Jilin Uiniv:Med Edit, 2017, 43 (4) :787-793. (in Chinese) 牛猛, 邓大勇, 李云鹏飞, 等.磁共振弹性成像对肝纤维化分级诊断价值的Meta分析[J].吉林大学学报:医学版, 2017, 43 (4) :787-793.
    [9] LEI JW, TAN BB, LI WB, et al. Value of transient elastography measured with FibroTouch in the diagnosis of liver fibrosis in chronic hepatitis patients with hepatocellular carcinoma[J]. Chin J Med Offic, 2017, 45 (9) :930-933. (in Chinese) 雷洁雯, 谭碧波, 李万斌, 等. FibroTouch瞬时弹性成像诊断慢性乙型肝炎合并肝癌患者肝纤维化程度应用研究[J].临床军医杂志, 2017, 45 (9) :930-933.
    [10] SARIN SK, KUMAR M, LAU GK, et al. Asian-Pacific clinical practice guidelines on the management of hepatitis B:A 2015 update[J]. Hepatol Int, 2016, 10 (1) :1-98.
    [11] Panel of Elastography Assessment of Liver Fibrosis, Study Group of Interventional Ultrasound, Society of Ultrasound in Medicine of Chinese Medical Association. Guidelines for clinical application of two-dimensional shearwave elastography in assessment of liver fibrosis in chronic hepatitis B[J]. J Clin Hepatol, 2018, 34 (2) :255-261. (in Chinese) 中华医学会超声医学分会介入超声学组弹性成像评估肝纤维化专家组.二维剪切波弹性成像评估慢性乙型肝炎肝纤维化临床应用指南[J].临床肝胆病杂志, 2018, 34 (2) :255-261.
    [12] Chinese Society of Hepatology and Chinese Society of Infectious Disease, Chinese Medical Association. The guideline of prevention and treatment for chronic hepatitis B:a 2015 update[J]. J Clin Hepatol, 2015, 31 (12) :1941-1960. (in Chinese) 中华医学会肝病学分会, 中华医学会感染病学分会.慢性乙型肝炎防治指南 (2015年更新版) [J].临床肝胆病杂志, 2015, 31 (12) :1941-1960.
    [13] CHANGTIAN LI, CHANGSHENG ZHANG, JUNLAI LI, et al. Diagnostic accuracy of real-time shear wave elastography for staging of liver fibrosis:A meta-analysis[J]. Med Sci Monit, 2016, 22:1349-1359.
    [14] JIANG T, TIAN G, ZHAO Q, et al. Diagnostic accuracy of 2D-shear wave elastography for liver fibrosis severity:A Meta-analysis[J].PLo S One, 2016, 11 (6) :e0157219.
    [15] HAN XM, ZHANG Z, WANG XM, et al. Analysis of influence factors on hepatic elasticity measurement with shear wave elastography[J/CD]. Chin J Med Ultrasound:Electronic Edition, 2014, 11 (12) :18-21. (in Chinese) 韩秀梅, 张震, 王学梅, 等.剪切波弹性成像技术测量肝脏弹性的影响因素分析[J/CD].中华医学超声杂志:电子版, 2014, 11 (12) :18-21.
    [16] HIROTOSHI E, HIDETSUGU S, MINA K, et al. Evaluation of liver fibrosis by transient elastography using acoustic radiation force impulse:Comparison with Fibroscan (?) [J]. J Gastroenterol, 2011, 46 (10) :1238-1248.
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Article Metrics

    Article views (2069) PDF downloads(332) Cited by()
    Proportional views
    Related

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return