实时剪切波弹性成像技术测量肝脾硬度联合肝脂肪变性指数在诊断脂肪肝中的应用价值研究

doi:10.12117/jccmi.2019.06.010

Abstract
Figure/Table
References (26)
Related Citation (15)

Download: PDF (0 KB) HTML (1 KB)
Export: BibTeX | EndNote (RIS)

Abstract Objective: To study the application value of liver and spleen stiffness measured by real-time shear wave elastography(SWE) combined with hepatic steatosis index(HSI) to diagnosis the severity of hepatic steatosis in non-alcoholic fatty liver disease(NAFLD). Methods: Patients who met the inclusion criteria and treated at the First Affiliated Hospital of Xi’an Jiaotong University from January 2017 to June 2018 were included. Referring to the upper abdominal CT scan results, we divided the included patients into four groups as: control group and mild, moderate, severe fatty liver groups. Comparing liver stiffness(LS) and spleen stiffness(SS) measured by SWE and HSI between groups was performed. Calculate the ROC curves of single and joint indicators for diagnosis hepatic steatosis. Results: LS, SS and HSI were all significantly different among groups(P<0.05). After comparing between any two means, we found LS, SS and HSI have poor ability to identify adjacent levels of fatty liver. So we just calculated the ROC curves for diagnosing moderate to severe fatty liver. The area under the ROC curves(AUROC) were 0.895±0.030, 0.730±0.041 and 0.788±0.036(P<0.05) respectively. The critical values were 7.35 kPa, 23.65 kPa and 36.32 respectively. Finally, we calculated the joint indicators’ ROC curves. The AUROC of LS+HSI was 0.904±0.028(P<0.05), the sensitivity was 88.3% and the specificity was 87.0%. The AUROC of SS+HSI was 0.824±0.033(P<0.05), the sensitivity was 75.0% and the specificity was 77.2%. Conclusion: LS and SS measured by SWE combine with HSI can accurately detect moderate to severe NAFLD. LS+HSI had the highest diagnostic performance than others with a good clinical value.

Key words： Fatty liver Ultrasonography, Doppler, color Tomography, X-ray computed

Received: 28 June 2018

PACS:	Ｒ575
	Ｒ445.1
	Ｒ814.42

	Service

	E-mail this article
	Add to my bookshelf
	Add to citation manager
	E-mail Alert
	RSS
	Articles by authors
	GUO Yun-lei
	RUAN Li-tao
	DANG Ying
	BAI Xiao-fang
	CHEN Hong
	WANG Xiang
	LI Ning
	LI Yue-jiao

Cite this article:

GUO Yun-lei,RUAN Li-tao,DANG Ying, et al. Application value of liver and spleen stiffness measured by real-time shear wave elastography combined with hepatic steatosis index in diagnosis of hepatic steatosis[J]. JOURNAL OF CHINA MEDICAL IMAGING, 2019, 30(6): 416-420.

URL:

http://www.jccmi.com.cn/EN/10.12117/jccmi.2019.06.010 OR http://www.jccmi.com.cn/EN/Y2019/V30/I6/416

[1]Zhu JZ, Dai YN, Wang YM, et al. Prevalence of Nonalcoholic Fatty Liver Disease and Economy[J]. Dig Dis Sci, 2015, 60(11): 3194-3202.
[2]Nakashima K, Shiina T, Sakurai M, et al. JSUM ultrasound elastography practice guidelines: liver[J]. J Med Ultrasonics, 2013, 40(4): 325-357.
[3]Grgurevic I, Puljiz Z, Brnic D, et al. Liver and spleen stiffness and their ratio assessed by real-time two dimensional-shear wave elastography in patients with liver fibrosis and cirrhosis due to chronic viral hepatitis[J]. Eur Radiol, 2015, 25(11): 3214-3221.
[4]Liu JH, Zou Y, Chang W, et al. Assessment of Liver Fibrosis Using Real-time Shear-wave Elastography for Patients with Hepatitis B e Antigen-negative Chronic Hepatitis B and Alanine Transaminase <2 Times the Upper Limit of Normal[J]. Rev Invest Clin, 2017, 69(5): 254-261.
[5]汪惠鹏，刘艳君，王学梅．实时剪切波弹性成像在非酒精性脂肪肝分度诊断中的应用价值[J]．临床超声医学杂志，2017，19（4）：249-251．
[6]Barrea L, Di Somma C, Muscogiuri G, et al. Nutrition, inflammation and liver-spleen axis[J]. Crit Rev Food Sci Nutr, 2018, 58(18): 3141-3158.
[7]Hirooka M, Koizumi Y, Miyake T, et al. Nonalcoholic fatty liver disease: portal hypertension due to outflow block in patients without cirrhosis[J]. Radiology, 2015, 274(2): 597-604.
[8]Kramer H, Pickhardt PJ, Kliewer MA, et al. Accuracy of Liver Fat Quantification With Advanced CT, MRI, and Ultrasound Techniques: Prospective Comparison With MR Spectroscopy[J]. Am J Roentgenol, 2017, 208(1): 92-100.
[9]中华医学会肝病学分会脂肪肝和酒精性肝病学组．非酒精性脂肪性肝病诊疗指南（2010年修订版）[J]．中华肝脏病杂志，2010，18（3）：163-166．
[10]Hirata A, Sugiyama D, Kuwabara K, et al. Fatty liver index predicts incident diabetes in a Japanese general population with and without impaired fasting glucose[J]. Hepatol Res, 2018, 48(9): 708-716.
[11]Lee JH, Kim D, Kim HJ, et al. Hepatic steatosis index: a simple screening tool reflecting nonalcoholic fatty liver disease[J]. Dig Liver Dis, 2010, 42(7): 503-508.
[12]Munteanu M, Tiniakos D, Anstee Q, et al. Diagnostic performance of FibroTest, SteatoTest and ActiTest in patients with NAFLD using the SAF score as histological reference[J]. Aliment Pharmacol Ther, 2016, 44(8): 877-889.
[13]Poynard T, Pham T, Perazzo H, et al. Real-Time Shear Wave versus Transient Elastography for Predicting Fibrosis: Applicability, and Impact of Inflammation and Steatosis: A Non-Invasive Comparison[J]. PLoS One, 2016, 11(10): e0163276.
[14]Kjrgaard M, Thiele M, Jansen C, et al. High risk of misinterpreting liver and spleen stiffness using 2D shear-wave and transient elastography after a moderate or high calorie meal[J]. PLoS One, 2017, 12(4): e0173992.
[15]Samir AE, Dhyani M, Vij A, et al. Shear-Wave Elastography for the Estimation of Liver Fibrosis in Chronic Liver Disease: Determining Accuracy and Ideal Site for Measurement[J]. Radiology, 2015, 274(3): 888-896.
[16]Elkrief L, Rautou PE, Ronot M, et al. Prospective comparison of spleen and liver stiffness by using shear wave and transient elastography for detection of portal hypertension in cirrhosis[J]. Radiology, 2015, 275(2): 589-598.
[17]王屹．影像学在非酒精性脂肪性肝病临床研究及实践中的地位[J]．临床肝胆病杂志，2017，33（12）：2307-2310．
18]贾天利，孙尧，凌雪英，等．非酒精性脂肪肝病的磁共振检查技术的最新进展[J]．临床放射学杂志，2015，34（8）：1333-1335．
[19]Su TH, Liao CH, Liu CH, et al. Acoustic Radiation Force Impulse US Imaging: Liver Stiffness in Patients with Chronic Hepatitis B with and without Antiviral Therapy[J]. Radiology, 2018, 288(1): 293-299.
[20]Korda D, Lenard ZM, Gerlei Z, et al. Shear-wave elastography for the assessment of liver fibrosis in liver transplant recipients treated for hepatitis C virus recurrence[J]. Eur J Gastroenterol Hepatol, 2018, 30(1): 27-32.
[21]Jansen C, Bogs C, Verlinden W, et al. Shear-wave elastography of the liver and spleen identifies clinically significant portal hypertension: A prospective multicentre study[J]. Liver Int, 2017, 37(3): 396-405.
[22]Lu Y, Wei J, Tang Y, et al. Evaluation of fatty liver fibrosis in rabbits using real-time shear wave elastography[J]. Exp Ther Med, 2014, 8(2): 355-362.
[23]李玲，贺鹏，唐盈，等．剪切波弹性成像技术对兔脂肪肝硬度的研究[J]．中华医学超声杂志：电子版，2015，12（8）：657-662．
[24]Pawlus A, Inglot MS, Szymańska K, et al. Shear wave elastography of the spleen: evaluation of spleen stiffness in healthy volunteers[J]. Abdom Radiol(NY), 2016, 41(11): 2169-2174.
[25]曾静，范建高．脾脏硬度检测在慢性肝病无创诊断中的应用[J]．实用肝脏病杂志，2015，18（2）：209-212．
[26]Xu L, Lu W, Li P, et al. A comparison of hepatic steatosis index, controlled attenuation parameter and ultrasound as noninvasive diagnostic tools for steatosis in chronic hepatitis B[J]. Dig Liver Dis, 2017, 49(8): 910-917.