肾剪切波弹性成像对肝硬化的预测价值

IF 4 3区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Digestive and Liver Disease Pub Date : 2024-10-26 DOI:10.1016/j.dld.2024.10.018

Christian Hagel, Michael Hirth, Jan Bißbort, Andreas Teufel, Svetlana Hetjens, Matthias P Ebert, Christoph Antoni

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引用次数: 0

摘要

背景：肝硬化患者的预后受到肾功能的严重影响。本研究评估了通过点剪切波弹性成像测量肾脏僵硬度和通过双工超声测量肾脏灌注的实用性：在这项病例对照研究中，使用点剪切波弹性成像技术和双工超声技术对 123 名患者的器官僵硬度进行量化，以计算动脉阻力指数（RI）和搏动指数（PI），这些患者包括伴有腹水（LC+A）和无腹水（LC-A）的肝硬化患者以及无肝硬化（NLC）患者：结果：与 NLC 相比，LC-A 和 LC+A 患者的 PI 和 RI 均明显增加（p）：点剪切波弹性成像和双工超声波成像与肝硬化的进展相关，但只有剪切波弹性成像是肝硬化患者肝肾综合征和死亡率的重要预后工具。

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Predictive value of renal shear wave elastography in liver cirrhosis.

Background: In liver cirrhosis, prognosis is profoundly affected by renal function. This study evaluates the usefulness of renal stiffness measurement by point-shear wave elastography and renal perfusion by duplex.

Methods: In this case-control study, organ stiffness was quantified using point-shear wave elastography and duplex sonography to calculate the arterial resistive (RI) and pulsatility indices (PI) in 123 patients, including patients with liver cirrhosis with (LC+A) and without ascites (LC-A) and patients without liver cirrhosis (NLC).

Results: PI and RI were significantly increased in LC-A and LC+A compared to NLC (p<0.001) and correlated with MELD and Child Pugh scores. Point-shear wave elastography showed significantly lower renal stiffness in LC+A compared to LC-A (p<0.01) and NLC (p<0.001). Renal stiffness correlated inversely with MELD and Child Pugh scores. Reduced renal stiffness, but not PI or RI, was associated with the presence of hepatorenal syndrome (p<0.001). Reduced renal stiffness was associated with an increased risk of death due to complications of liver cirrhosis within 3 years (p<0.01).

Conclusion: Point-shear wave elastography and duplex sonography correlate with progression of liver cirrhosis, but only shear wave elastography represents a valuable prognostic tool for hepatorenal syndrome and mortality in patients with liver cirrhosis.

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来源期刊

Digestive and Liver Disease 医学-胃肠肝病学

CiteScore

6.10

自引率

2.20%

发文量

632

审稿时长

19 days

期刊介绍： Digestive and Liver Disease is an international journal of Gastroenterology and Hepatology. It is the official journal of Italian Association for the Study of the Liver (AISF); Italian Association for the Study of the Pancreas (AISP); Italian Association for Digestive Endoscopy (SIED); Italian Association for Hospital Gastroenterologists and Digestive Endoscopists (AIGO); Italian Society of Gastroenterology (SIGE); Italian Society of Pediatric Gastroenterology and Hepatology (SIGENP) and Italian Group for the Study of Inflammatory Bowel Disease (IG-IBD). Digestive and Liver Disease publishes papers on basic and clinical research in the field of gastroenterology and hepatology. Contributions consist of: Original Papers Correspondence to the Editor Editorials, Reviews and Special Articles Progress Reports Image of the Month Congress Proceedings Symposia and Mini-symposia.