Meta-analysis: ARFI elastography versus transient elastography for the evaluation of liver fibrosis

被引:353
作者
Bota, Simona [1 ]
Herkner, Harald [2 ]
Sporea, Ioan [1 ]
Salzl, Petra [3 ]
Sirli, Roxana [1 ]
Neghina, Adriana M. [4 ]
Peck-Radosavljevic, Markus [3 ]
机构
[1] Victor Babes Univ Med & Pharm, Dept Gastroenterol & Hepatol, Timisoara, Romania
[2] Med Univ Vienna, Dept Emergency Med, Vienna, Austria
[3] Med Univ Vienna, Dept Gastroenterol & Hepatol, Vienna, Austria
[4] Victor Babes Univ Med & Pharm, Dept Biochem, Timisoara, Romania
关键词
ARFI; acoustic radiation force impulse elastography; fibroscan((R)); liver fibrosis; liver stiffness; transient elastography; RADIATION FORCE IMPULSE; CHRONIC HEPATITIS-C; REAL-TIME ELASTOGRAPHY; NONINVASIVE ASSESSMENT; STIFFNESS MEASUREMENT; SAMPLING VARIABILITY; VIRAL-HEPATITIS; OBESE-PATIENTS; FIBROSCAN(R); PERFORMANCE;
D O I
10.1111/liv.12240
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Aims This meta-analysis aims to compare the diagnostic performance of acoustic radiation force impulse (ARFI) elastography and transient elastography (TE) in the assessment of liver fibrosis using liver biopsy (LB) as gold-standard'. Methods PubMed, Medline, Lilacs, Scopus, Ovid, EMBASE, Cochrane and Medscape databases were searched for all studies published until 31 May 2012 that evaluated the liver stiffness by means of ARFI, TE and LB. Information abstracted from each study according to a fixed protocol included study design and methodological characteristics, patient characteristics, interventions, outcomes and missing outcome data. Results Thirteen studies (11 full-length articles and 2 abstracts) including 1163 patients with chronic hepatopathies were included in the analysis. Inability to obtain reliable measurements was more than thrice as high for TE as that of ARFI (6.6% vs. 2.1%, P<0.001). For detection of significant fibrosis, (F2) the summary sensitivity (Se) was 0.74 (95% CI: 0.66-0.80) and specificity (Sp) was 0.83 (95% CI: 0.75-0.89) for ARFI, while for TE the Se was 0.78 (95% CI: 0.72-0.83) and Sp was 0.84 (95% CI: 0.75-0.90). For the diagnosis of cirrhosis, the summary Se was 0.87 (95% CI: 0.79-0.92) and Sp was 0.87 (95% CI: 0.81-0.91) for ARFI elastography, and, respectively, 0.89 (95% CI: 0.80-0.94) and 0.87 (95% CI: 0.82-0.91) for TE. The diagnostic odds ratio of ARFI and TE did not differ significantly in the detection of significant fibrosis [mean difference in rDOR=0.27 (95% CI: 0.69-0.14)] and cirrhosis [mean difference in rDOR=0.12 (95% CI: 0.29-0.52)].Conclusion Acoustic radiation force impulse elastography seems to be a good method for assessing liver fibrosis, and shows higher rate of reliable measurements and similar predictive value to TE for significant fibrosis and cirrhosis.
引用
收藏
页码:1138 / 1147
页数:10
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