Direct Comparison of US and MR Elastography for Staging Liver Fibrosis in Patients With Nonalcoholic Fatty Liver Disease

被引:82
作者
Imajo, Kento [1 ]
Honda, Yasushi [1 ]
Kobayashi, Takashi [1 ]
Nagai, Koki [1 ]
Ozaki, Anna [1 ]
Iwaki, Michihiro [1 ]
Kessoku, Takaomi [1 ]
Ogawa, Yuji [1 ]
Takahashi, Hirokazu [2 ]
Saigusa, Yusuke [3 ]
Yoneda, Masato [1 ]
Kirikoshi, Hiroyuki [4 ]
Utsunomiya, Daisuke [5 ]
Aishima, Shinichi [6 ]
Saito, Satoru [1 ]
Nakajima, Atsushi [1 ]
机构
[1] Yokohama City Univ, Dept Gastroenterol, Grad Sch Med, Yokohama, Kanagawa, Japan
[2] Saga Univ, Saga Univ Hosp, Ctr Liver, Fac Med, Saga, Japan
[3] Yokohama City Univ, Sch Med, Dept Biostat, Yokohama, Kanagawa, Japan
[4] Yokohama City Univ Med, Dept Clin Lab, Yokohama, Kanagawa, Japan
[5] Yokohama City Univ, Dept Radiol, Grad Sch Med, Yokohama, Kanagawa, Japan
[6] Saga Univ, Dept Pathol & Microbiol, Fac Med, Saga, Japan
基金
日本科学技术振兴机构;
关键词
Nonalcoholic Fatty Liver Disease; Magnetic Resonance Elastography; Two-Dimensional Shear Wave Elastography; Vibration-Controlled Transient Elastography; Intra- and Inter-Observer Reproducibility; MAGNETIC-RESONANCE ELASTOGRAPHY; TRANSIENT ELASTOGRAPHY; STIFFNESS MEASUREMENT; ULTRASOUND ELASTOGRAPHY; DIAGNOSTIC PERFORMANCE; HEPATIC-FIBROSIS; XL PROBE; STEATOHEPATITIS; BIOPSY; FEASIBILITY;
D O I
10.1016/j.cgh.2020.12.016
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
BACKGROUND & AIMS: As alternatives to the expensive liver biopsy for assessing liver fibrosis stage in patients with nonalcoholic fatty liver disease (NAFLD), we directly compared the diagnostic abilities of magnetic resonance elastography (MRE), vibration-controlled transient elastography (VCTE), and two-dimensional shear wave elastography (2D-SWE). METHODS: Overall, 231 patients with biopsy-proven NAFLD were included. Intra- and inter-observer reproducibility was analyzed using intraclass correlation coefficient in a sub-group of 70 participants, in whom liver stiffness measurement (LSM) was performed by an elastography expert and an ultrasound expert who was an elastography trainee on the same day. RESULTS: Valid LSMs were obtained for 227, 220, 204, and 201 patients using MRE, VCTE, 2D-SWE, and all three modalities combined, respectively. Although the area under the curve did not differ between the modalities for detecting stage >= 1, >= 2, and >= 3 liver fibrosis, it was higher for MRE than VCTE and 2D-SWE for stage 4. Sex was a significant predictor of discordance between VCTE and liver fibrosis stage. Skin-capsule distance and the ratio of the interquartile range of liver stiffness to the median were significantly associated with discordance between 2D-SWE and liver fibrosis stage. However, no factors were associated with discordance between MRE and liver fibrosis stage. Intra- and inter-observer reproducibility in detecting liver fibrosis was higher for MRE than VCTE and 2D-SWE. CONCLUSIONS: MRE, VCTE, and 2D-SWE demonstrated excellent diagnostic accuracy in detecting liver fibrosis in patients with NAFLD. MRE demonstrated the highest diagnostic accuracy for stage 4 detection and intra- and inter-observer reproducibility.
引用
收藏
页码:908 / +
页数:21
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