Assessing liver fibrosis in chronic liver disease: Comparison of diffusion-weighted MR elastography and two-dimensional shear-wave elastography using histopathologic assessment as the reference standard

IF 3.7 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY
Li Yang , Guofeng Zhou , Liheng Liu , Shengxiang Rao , Wentao Wang , Kaipu Jin , Caixia Fu , Mengsu Zeng , Ying Ding
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引用次数: 0

Abstract

Introduction and Objectives

Liver stiffness measurement (LSM) by two-dimensional shear-wave elastography (2D SWE) is a well-established method for assessing hepatic fibrosis. Diffusion-weighted imaging (DWI) can be converted into virtual shear modulus (µDiff) to estimate liver elasticity. The purpose of this study was to correlate and compare the diagnostic performance of DWI-based virtual elastography and 2D SWE for staging hepatic fibrosis in patients with chronic liver disease, using histopathologic assessment as the reference standard.

Patients and Methods

This retrospective study included 111 patients who underwent preoperative multiple b-value DWI and 2D SWE. The µDiff was calculated using DWI acquisition with b-values of 200 and 1,500 /mm2, and LSM was obtained by 2D SWE. Correlation between µDiff and LSM was assessed, as well as the correlation between these noninvasive methods and histologic fibrosis stages. The diagnostic efficacy of µDiff and LSM for staging liver fibrosis was compared with receiver operating characteristic (ROC) curve analysis.

Results

There was a significant positive correlation between µDiff and LSM (rho= 0.48, P < 0.001). µDiff (rho= 0.54, P < 0.001) and LSM (rho= 0.76, P < 0.001) were positively correlated with liver fibrosis stages. Areas under the curves (AUCs) of µDiff and LSM, respectively, were 0.81 and 0.90 for significant fibrosis, 0.89 and 0.98 for advanced fibrosis, and 0.77 and 0.91 for cirrhosis. The AUCs of 2D SWE for diagnosing advanced fibrosis and cirrhosis were significantly higher than those of µDiff (P < 0.05 for both).

Conclusions

LSM by 2D SWE yields larger AUCs compared to µDiff obtained from DWI-based virtual elastography for various stages of liver fibrosis. LSM is superior to µDiff in predicting advanced fibrosis and cirrhosis.
慢性肝病肝纤维化评估:以组织病理学评估为参考标准的弥散加权MR弹性成像与二维剪切波弹性成像的比较
简介和目的:通过二维剪切波弹性成像(2D SWE)测量肝脏硬度(LSM)是一种公认的评估肝纤维化的方法。扩散加权成像(DWI)可以转换为虚拟剪切模量(µDiff)来估计肝脏弹性。本研究的目的是以组织病理学评估为参考标准,将基于dwi的虚拟弹性成像与2D SWE对慢性肝病患者肝纤维化分期的诊断性能进行关联和比较。患者和方法:本回顾性研究纳入111例术前行b值DWI和2D SWE检查的患者。利用b值为200和1500 /mm2的DWI采集计算µDiff,并通过2D SWE获得LSM。评估µDiff和LSM之间的相关性,以及这些无创方法与组织学纤维化分期之间的相关性。采用受试者工作特征(ROC)曲线分析比较µDiff和LSM对肝纤维化分期的诊断效果。结果:µDiff与LSM呈显著正相关(rho= 0.48), PDiff与LSM呈显著正相关(rho= 0.54),显著纤维化PDiff与LSM分别为0.81、0.90,晚期纤维化PDiff与0.89、0.98,肝硬化PDiff与LSM分别为0.77、0.91。2D SWE诊断晚期纤维化和肝硬化的auc显著高于µDiff (P)。结论:对于不同阶段的肝纤维化,与基于dwi的虚拟弹性成像获得的µDiff相比,2D SWE的LSM产生更大的auc。LSM在预测晚期纤维化和肝硬化方面优于µDiff。
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来源期刊
Annals of hepatology
Annals of hepatology 医学-胃肠肝病学
CiteScore
7.90
自引率
2.60%
发文量
183
审稿时长
4-8 weeks
期刊介绍: Annals of Hepatology publishes original research on the biology and diseases of the liver in both humans and experimental models. Contributions may be submitted as regular articles. The journal also publishes concise reviews of both basic and clinical topics.
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