通过 100 赫兹振动控制瞬态弹性成像测量脾脏硬度、肝脏硬度、APRI 评分及其组合预测肝硬化食管静脉曲张的性能。

IF 2.6 4区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY
Juferdy Kurniawan, Billy Stinggo Paskharan Siahaan
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引用次数: 0

摘要

背景:食管静脉曲张(EV)破裂仍是肝硬化最严重的并发症之一。作为预测这一事故的金标准,食管胃十二指肠镜检查(EGD)本身也有弱点。在临床实践中,除了风险和费用负担外,并非所有患者都能方便地接受这种检查。因此,寻找其他具有高准确性的无创方法仍然值得关注。其中,100Hz 探头脾脏硬度测量(SSM)、肝脏硬度测量(LSM)和天门冬氨酸氨基转移酶与血小板比值指数(APRI)评分因其良好的准确性而受到广泛欢迎和深入研究,但结果仍相互矛盾。本研究旨在探讨 SSM、LSM、APRI 评分及其组合作为肝硬化患者 EV 预测筛查工具的性能:在这项横断面研究中,我们纳入了 141 名在 2023 年 1 月至 3 月间接受过内镜检查、SSM、LSM 和 APRI 评分计算的肝硬化患者。诊断准确性通过接收器操作曲线下面积(AUC)进行评估。瞬态弹性成像(TE)测量是使用脾脏专用的纤维扫描仪和 100 Hz 探头进行的:结果:在 141 名患者中,最常见的病因是乙型肝炎,占 71 名患者(50.4%)。116名患者中发现了EV。根据 AUC 值,以 40 kPa 为临界值的 SSM 性能最佳,AUC 值为 0.892(CI 95%:0.814 - 0.969, p
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Performance of spleen stiffness measurement by 100‐Hz vibration‐controlled transient elastography, liver stiffness, APRI score and their combination for predicting oesophageal varices in liver cirrhosis

Background

Oesophageal varices (EV) rupture remains one of the most severe complications of cirrhosis. As the gold standard to predict this accident, esophagogastroduodenoscopy (EGD) itself also has a weakness. Not all patients are convenient with this modality in clinical practice apart from the risk and cost burden. Hence, the search for other non-invasive modalities with high accuracy is still noteworthy. Among them, spleen stiffness measurement (SSM) with 100 Hz probe, liver stiffness measurement (LSM), and the aspartate amino transferase to platelet ratio index (APRI) score became popular and intensively studied with good accuracy, but the results remain conflicting. This study aims to investigate the performance of SSM, LSM, APRI score, and their combination especially as a screening tool for predicting EV in liver cirrhosis patients.

Methods

In this cross-sectional study, we included 141 patients with liver cirrhosis who had undergone endoscopy, SSM, LSM, and APRI score calculation between January and March 2023 were enrolled. Diagnostic accuracy was assessed by the area under the receiver-operator curve (AUC). Transient elastography (TE) measurement was performed using a spleen-dedicated FibroScan with a 100-Hz probe.

Results

Of the 141 patients, the most common aetiology was hepatitis B in 71 patients (50.4 %). EV were found in 116 patients. Using the AUC, SSM at a cutoff of 40 kPa had the best performance with an AUC of 0.892 (CI 95 %: 0.814–0.969, p <0.0001), with sensitivity 88.79 % and specificity 80 %). Meanwhile, LSM and APRI score had an AUC of 0.832 (CI 95 %: 0.742–0.922, p <0.0001) and 0.780 (CI 95 %: 0.660–0.900, p <0.0001), respectively. The combination of all measurement tools did not show better performance than SSM alone with an AUC of 0.892 (CI 95 %: 0.802–0.982, P <0.0001)

Conclusion

SSM provides better performance than LSM and APRI scores for predicting EV. Performance of SSM alone is non-inferior compare to multiple diagnostic tools combined.

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来源期刊
CiteScore
4.30
自引率
3.70%
发文量
198
审稿时长
42 days
期刊介绍: Clinics and Research in Hepatology and Gastroenterology publishes high-quality original research papers in the field of hepatology and gastroenterology. The editors put the accent on rapid communication of new research and clinical developments and so called "hot topic" issues. Following a clear Editorial line, besides original articles and case reports, each issue features editorials, commentaries and reviews. The journal encourages research and discussion between all those involved in the specialty on an international level. All articles are peer reviewed by international experts, the articles in press are online and indexed in the international databases (Current Contents, Pubmed, Scopus, Science Direct). Clinics and Research in Hepatology and Gastroenterology is a subscription journal (with optional open access), which allows you to publish your research without any cost to you (unless you proactively chose the open access option). Your article will be available to all researchers around the globe whose institution has a subscription to the journal.
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