Assessing significant fibrosis using imaging-based elastography in chronic hepatitis B patients: Pilot study
Assessing significant fibrosis using imaging-based elastography in chronic hepatitis B patients: Pilot study作者机构：Department of RadiologyKonkuk University School of MedicineSeoul 05030South Korea Department of Internal MedicineKonkuk University School of MedicineSeoul 05030South Korea Department of PathologyKonkuk University School of MedicineSeoul 05030South Korea
出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)
年 卷 期：2019年第25卷第25期
页 面：3256-3267页
核心收录：
主 题：Antiviral therapy Chronic hepatitis B Liver fibrosis Magnetic resonance elastography Ultrasound elastography
摘 要：BACKGROUND Accurate detection of significant fibrosis(fibrosis stage 2 or higher on the METAVIR scale)is important especially for chronic hepatitis B(CHB)patients with high viral loads but with normal or mildly elevated alanine aminotransferase(ALT)levels because the presence of significant fibrosis is accepted as the indication for antiviral *** biopsy is the reference standard for diagnosing significant fibrosis,but it is an invasive ***,noninvasive imaging-based measurements,such as magnetic resonance elastography(MRE)or two-dimensional shear-wave elastography(2DSWE),have been proposed for the quantitative assessment of liver *** To explore MRE and 2D-SWE to identify fibrosis stage,and to compare their performance with that of serum-based *** The study enrolled 63 treatment-na?ve CHB patients with high viral loads but with normal or mildly elevated ALT levels who underwent liver biopsy before a decision was made to initiate antiviral *** and 2D-SWE were performed,and serum-based indices,such as FIB-4 and aspartate transaminase to platelet ratio index(APRI),were *** diagnostic performances of MRE,2D-SWE,FIB-4,and APRI for assessing significant fibrosis(≥F2)and cirrhosis(F4)were evaluated with liver histology as the reference standard,using receiver operating characteristic *** The liver fibrosis stage was F0/F1 in 19,F2 in 14,F3 in 14,and F4 in 16 patients,*** significantly discriminated F2 from F0/1(P=0.022),whereas 2D-SWE showed a broad overlap in distinguishing those *** showed a higher correlation coefficient value with fibrosis stage than 2D-SWE with fibrosis stage(0.869 vs 0.649,Spearman test;P0.001).Multivariate linear regression analyses showed that fibrosis stage was the only factor affecting the values of MRE(P0.001),whereas body mass index(P=0.042)and fibrosis stage(P0.001)were independent factors affecting 2D-SWE *** performance for diagnos
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