| 摘要: |
| 目的 评估点剪切波弹性成像(pSWE)和瞬态弹性成像(TE)两种方法对非酒精性脂肪肝(NAFLD)患者肝纤维化分期的准确性。方法 计算机检索万方数据库、中国生物医学文献数据库(CBM)、中国学术期刊全文数据库/中国知网(CNKI)、PubMed、Web of Science、EMbase和Cochrane Library数据库。收集建库以来至2023年2月1日的相关研究,所有受试者均为NAFLD患者,且在肝活检前用两种超声方法测量肝脏硬度,排除既往有肝脏损害病史者,如慢性丙型肝炎、合并活动性乙型肝炎病毒感染、自身免疫性肝病和可疑吸毒和酗酒者。采用双变量混合效应模型分析两种超声诊断的敏感度、特异度、阳性似然比、阴性似然比和受试者工作特征曲线下面积(AUC)。由两名评价员分别独立筛选文献、提取资料并进行偏倚风险评估,利用敏感性分析探索各项研究之间的异质性。Stata 11.0软件进行Meta分析。结果6项pSWE研究包括563名患者,共有1897名患者参与了11项TE研究,用于检测严重肝纤维化、晚期肝纤维化和肝硬化。pSWE总的AUC分别为0.85(95%CI: 0.82-0.88)、0.95(95%CI: 0.91-0.97)和0.93(95%CI: 0.91-0.96)；TE总的AUC分别为0.83(95%CI: 0.82-0.85)、0.90(95%CI: 0.89-0.93)和0.94(95%CI: 0.91-0.96)。使用M探头的TE测量失败率较pSWE高。结论 pSWE和TE均可提供无创、精确的NAFLD肝纤维化分期,尤其是晚期肝纤维化和肝硬化,具有良好的应用前景。 |
| 关键词: 剪切波弹性成像 瞬态弹性成像 非酒精性脂肪肝 肝纤维化 |
| DOI： |
| 投稿时间：2024-02-27修订日期：2024-09-21 |
| 基金项目: |
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| Evaluation of diagnostic accuracy of point shear wave elastography and transient elastography in the staging of liver fibrosis in patients with nonalcoholic fatty liver disease |
| LI LINGZI,YANG QIAN,MA XIAOMING |
| () |
| Abstract: |
| Objectives: This study aimed to evaluate the accuracy of point shear wave elastography (pswe) and transient elastography (TE) in the staging of liver fibrosis in patients with nonalcoholic fatty liver disease (NAFLD). Methods: Wanfang, CBM, CNKI, PubMed, Web of Science, Embase and Cochrane Library databases up to 1st February 2023 were searched by computer. All subjects were NAFLD patients, and liver hardness was measured by two ultrasonic methods before liver biopsy, excluding those with a history of liver damage, such as chronic hepatitis C, combined with active hepatitis B virus infection, autoimmune liver disease, and suspected drug users and alcoholics. The sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and the area under the working characteristic curve (AUC) of the subjects were analyzed by using a bivariate mixed effect model. Two evaluators independently screened the literature, extracted data, and assessed the risk of bias. Sensitivity analysis was used to explore the heterogeneity between various studies. Meta analysis was performed by Stata 11.0 software. Results: Six pSWE studies comprising a total of 563 patients and 11 TE studies comprising a total of 1897 patients were included. For detection of significant fibrosis, advanced fibrosis and cirrhosis, the summary AUC was 0.85 (95% CI 0.82 to 0.88), 0.95 (95% CI 0.91 to 0.97) and 0.93 (95% CI 0.91 to 0.96) for pSWE, and the summary AUC was 0.83 (95% CI 0.82 to 0.85), 0.90 (95% CI 0.89 to 0.93) and 0.94 (95% CI 0.91 to 0.96) for TE, respectively. The proportion of failure measurement was higher with TE using an M probe compared with pSWE. Conclusion: pSWE and TE, can provide noninvasive and accurate staging of NAFLD liver fibrosis, especially in advanced liver fibrosis and cirrhosis, and have a good application prospect. |
| Key words: point shear wave elastography transient elastography non-alcoholic fatty liver disease liver fibrosis stage |
