引导- vcte：一种增强纤维扫描检查，具有更好的指导和适用性。

IF 2.4 3区医学 Q2 ACOUSTICS

Ultrasound in Medicine and Biology Pub Date : 2025-01-13 DOI:10.1016/j.ultrasmedbio.2024.12.007

Cécile Bastard , Stéphane Audière , Julie Foucquier , Hugo Lorée , Véronique Miette , Jean-Pierre Bronowicki , Christiane Stern , Cyrielle Caussy , Laurent Sandrin

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引用次数: 0

摘要

目的：尽管基于振动控制瞬态弹性成像（VCTE）的FibroScan （FS）是一种广泛应用于评估肝纤维化和脂肪变性的无创设备，但其目前的标准VCTE检查在肥胖患者中仍然不够及时和困难。Guided-VCTE检查使用连续横波来定位肝脏，为横波传播提供实时预测指标，在难以评估的患者中使用横波图平均来提高信噪比。我们旨在评估新指标的有效性，并比较标准vcte和指导vcte考试的考试时间和成功率。方法：在这项多中心研究中，我们招募了130名不同BMI的患者。敏感性、特异性、阳性预测值和阴性预测值评价新指标的有效性。使用Wilcoxon符号秩检验比较成功率，使用时间到事件分析调查检查时间。采用Wilcoxon sign -rank检验评估两种方法的一致性和可重复性。结果：新指标非常有效，预测有效肝硬度测量（LSM）的灵敏度为97%。LSM和控制衰减参数的结果在两次测试之间保持良好的一致性。Guided-VCTE检查显著提高了个体测量的成功率，并显著减少了研究队列中定位所需的时间，特别是在2级肥胖（BMI≥35 kg/m²）患者中。此外，Guided-VCTE检查在不到4分钟内扫描的患者比例明显更高。结论：引导vcte是一种新的有效技术，可简化FS的进一步使用，特别是对于肥胖患者。

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Guided-VCTE: An Enhanced FibroScan Examination With Improved Guidance and Applicability

Objective

Although FibroScan (FS), based on Vibration-Controlled Transient Elastography (VCTE), is a widely used non-invasive device for assessing liver fibrosis and steatosis, its current standard-VCTE examination remains timely and difficult on patients with obesity. The Guided-VCTE examination uses continuous shear waves to locate the liver by providing a real-time predictive indicator for shear wave propagation and uses shear wave maps averaging to increase the signal-to-noise ratio in difficult to assess patients. We aimed to evaluate the effectiveness of the new indicator, as well as compare examination times and success rates with both standard-VCTE and Guided-VCTE examinations.

Methods

We recruited 130 patients all with varying BMI in this multicenter study. Sensitivity, specificity, positive predictive values and negative predictive values assessed the new indicator effectiveness. Success rates were compared using Wilcoxon signed rank tests rates and time-to-event analyses were used to investigate examination times. Agreement and repeatability of both methods were assessed using Wilcoxon signed-rank test.

Results

The new indicator was highly effective, with a 97% sensitivity for predicting valid liver stiffness measurements (LSM). LSM and controlled attenuation parameter results remained in good agreement between two examinations. The Guided-VCTE examination significantly increased the success rate of individual measurements and significantly reduced the time required for localization in the study cohort, especially in patients with grade 2 obesity (BMI ≥35 kg/m²). Additionally, the proportion of patients scanned in less than 4 minutes was significantly higher with the Guided-VCTE examination.

Conclusion

Guided-VCTE is a new effective technique that simplifies further FS use, particularly for patients with obesity.

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来源期刊

Ultrasound in Medicine and Biology 医学-核医学

CiteScore

6.20

自引率

6.90%

发文量

325

审稿时长

70 days

期刊介绍： Ultrasound in Medicine and Biology is the official journal of the World Federation for Ultrasound in Medicine and Biology. The journal publishes original contributions that demonstrate a novel application of an existing ultrasound technology in clinical diagnostic, interventional and therapeutic applications, new and improved clinical techniques, the physics, engineering and technology of ultrasound in medicine and biology, and the interactions between ultrasound and biological systems, including bioeffects. Papers that simply utilize standard diagnostic ultrasound as a measuring tool will be considered out of scope. Extended critical reviews of subjects of contemporary interest in the field are also published, in addition to occasional editorial articles, clinical and technical notes, book reviews, letters to the editor and a calendar of forthcoming meetings. It is the aim of the journal fully to meet the information and publication requirements of the clinicians, scientists, engineers and other professionals who constitute the biomedical ultrasonic community.