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Applicability and variability of liver stiffness measurements according to probe position

World Journal of Gastroenterology 2009年第27期15卷 3398-3404页

作者： Patrick Ingiliz Kim Pav Chhay Mona Munteanu Pascal Lebray Yen Ngo dominique Roulot Yves Benhamou dominique thabut Vlad Ratziu Thierry Poynard dominique thabut Vlad Ratziu Thierry Poynard AP-HP Hospital Group Pitié-Salpêtrière Hepatology Department47-83 Hospital Boulevard Paris 75651 France BioPredictive 40 Bac street Paris 75007 France AP-HP Hepatology Department Avicenne hospitalBobigny 93000France AP-HP Hospital Group Pitié-Salpêtrière Hepatology Department47-83 Hospital Boulevard Paris 75651 France

AIM: To investigate the liver stiffness measurement (LSM) applicability and variability with reference to three probe positions according to the region of liver biopsy. METHODS: The applicability for LSM was defined as at least 10 valid measurements with a success rate greater than 60% and an interquartile range/median LSM < 30%. The LSM variability compared the inter-position concordance and the concordance with FibroTest. RESULTS: Four hundred and forty two consecutive patients were included. The applicability of the anterior position (81%) was significantly higher than that of the reference (69%) and lower positions (68%), (both P = 0.0001). There was a signif icant difference (0.5 kPa, 95% CI 0.13-0.89; P < 0.0001) between mean LSM estimated at the reference position (9.3 kPa) vs the anterior position (8.8 kPa). Discordance between positions was associated with thoracic fold (P = 0.008). The discordance rate between the reference position result and FibroTest was higher when the 7.1 kPa cutoff was used to define advanced fibrosis instead of 8.8 kPa (33.6% vs 23.5%, P = 0.03).CONCLUSION: The anterior position of the probe should be the fi rst choice for LSM using Fibroscan, as it has a higher applicability without higher variability compared to the usual liver biopsy position.

关键词： Fibroscan Fibrotest Liver fibrosis Variability Concordance

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