瞬时弹性图诊断肝硬化:一项前瞻性研究

作     者：Foucher J. Chanteloup E. Vergniol J. V. De Lédinghen 王顺涛(译) 陈云茹(校) 

作者机构：不详 Service d'Hépato-Gastroentérologie Hoepital Haut Lévéque Avenue Magellan 33604 Pessac France 

出 版 物：《世界核心医学期刊文摘（胃肠病学分册）》 (Core Journals in Gastroenterology)

年 卷 期：2006年第2卷第8期

页      面：41-42页

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：肝硬化患者 前瞻性研究 弹性 肝纤维化程度 非酒精性脂肪肝 慢性肝病患者 诊断 肝脏硬度 纤维化分期 ROC曲线 

摘      要：Background: Transient elastography (FibroScan) is a new, noninvasive, rapid, and reproducible method allowing evaluation of liver fibrosis by measurement of liver stiffness. In cirrhotic patients, liver stiffness measurements range from 12.5 to 75.5 kPa. However, the clinical relevance of these values is unknown. The aim of this prospective study was to evaluate the accuracy of liver stiffness measurement for the detection of cirrhosis in patients with chronic liver disease. Methods: A total of 711 patients with chronic liver disease were studied. Aetiologies of chronic liver diseases were hepatitis C virus or hepatitis B virus infection, alcohol, non-alcoholic steatohepatitis, other, or a combination of the above aetiologies. Liver fibrosis was evaluated according to the METAVIR score. Results: Stiffness was significantly correlated with fibrosis stage (r=0.73, p 2), 0.90 (0.86- 0.93) for patients with severe fibrosis (F3), and 0.96 (0.94- 0.98) for patients with cirrhosis. Using a cut off value of 17.6 kPa, patients with cirrhosis were detected with a positive predictive value and a negative predictive value (NPV) of 90% . Liver stiffness was significantly correlated with clinical, biological, and morphological parameters of liver disease. With an NPV 90% , the cut off values for the presence of oesophageal varices stage 2/3, cirrhosis Child-Pugh B or C, past history of ascites, hepatocellular carcinoma, and oesophageal bleeding were 27.5, 37.5, 49.1, 53.7, and 62.7 kPa, respectively. Conclusion: Transient elastography is a promising non-invasive method for detection of cirrhosis in patients with chronic liver disease. Its use for the follow up and management of these patients could be of great interest and should be evaluated further.