ARFI成像评估脾脏和肝脏僵硬度:短期监测门静脉高压症的可靠工具?

IF 1.5 Q3 GASTROENTEROLOGY & HEPATOLOGY
International Journal of Hepatology Pub Date : 2022-09-09 eCollection Date: 2022-01-01 DOI:10.1155/2022/7384144
Andreas Binzberger, Mark Hänle, Matthias Pfahler, Wolfgang Kratzer, Thomas Seufferlein, Eugen Zizer
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引用次数: 0

摘要

背景:评估肝静脉压力梯度(HVPG)是评估门静脉高压症最可靠的方法,但有创性。无创,弹性成像为基础的技术是很好的诊断,但不是监测门静脉高压症。我们前瞻性研究的目的是确定声辐射力脉冲(ARFI)弹性成像技术在诊断和监测门静脉高压症中的价值。方法:我们通过HVPG和相应的肝脾弹性成像对31例肝硬化患者的门脉高压进行前瞻性评估,并确定非心脏选择性β受体阻滞剂一级预防的指征。在基线和6-8周后随访时进行调查。为了解决已知的脾脏弹性成像值的大变异性,在脾脏中定义明确的相应区域用于基线和随访弹性成像。计算脾脏和肝脏弹性图监测门静脉高压症的敏感性、特异性和AUC-ROC值。结果:肝弹性图与HVPG结果有显著相关性,脾弹性图与HVPG结果无显著相关性,适用于门静脉高压症的初步评价。然而,HVPG结果的变化与肝脏和脾脏弹性成像从基线到随访期间ARFI值的变化没有任何相关性。脾脏僵硬的结果在整个器官中不是均匀的,在上部、门部和底部放置的调查区域之间差异显著。结论:在这项前瞻性研究中,基于arfi的肝弹性成像评估适合于初步评估,但不适用于门脉高压的监测。脾弹性成像不适用于门脉高压的评估和监测。这一新数据与先前发表的结果有所不同,可能的解释是我们研究中门静脉高压的程度,相对较短的随访时间,以及在重复ARFI调查中脾脏弹性成像的明确研究区域。该试验注册号为NCT03315767。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Spleen and Liver Stiffness Evaluation by ARFI Imaging: A Reliable Tool for a Short-Term Monitoring of Portal Hypertension?

Spleen and Liver Stiffness Evaluation by ARFI Imaging: A Reliable Tool for a Short-Term Monitoring of Portal Hypertension?

Spleen and Liver Stiffness Evaluation by ARFI Imaging: A Reliable Tool for a Short-Term Monitoring of Portal Hypertension?

Spleen and Liver Stiffness Evaluation by ARFI Imaging: A Reliable Tool for a Short-Term Monitoring of Portal Hypertension?

Background: Assessment of hepatic venous pressure gradient (HVPG) is the most reliable, though invasive method for evaluation of portal hypertension. Non-invasive, elastography-based techniques are well established in diagnosis, but not in monitoring of portal hypertension. The aim of our prospective study was to determine the value of acoustic radiation force impulse (ARFI) elastography technique of the liver and spleen in diagnosis and monitoring of portal hypertension.

Methods: We prospectively assessed portal hypertension by HVPG and corresponding elastography of the liver and spleen in 31 patients with liver cirrhosis and an indication for primary prophylaxis by non-cardio selective beta-blockers. Investigations were performed at baseline and a follow-up visit after 6-8 weeks. To address the known large variability of values for spleen elastography, well-defined corresponding areas in the spleen were used for baseline and follow-up elastography. Sensitivity, specificity, and AUC-ROC values for both spleen and liver elastography monitoring of portal hypertension were calculated.

Results: Liver but not spleen elastography significantly correlated with HVPG results and was suitable for initial evaluation of portal hypertension. However, changes in HVPG results did not show any correlation with alterations of ARFI values from baseline to follow-up visits both for liver and spleen elastography. Spleen stiffness results were not homogeneous across the whole organ differing significantly between the upper, hilar, and bottom placed investigation areas.

Conclusions: In this prospective study ARFI-based assessment of liver elastography showed itself suitable for initial assessment but not for monitoring of portal hypertension. Spleen elastography was not appropriate for both, evaluation and monitoring of portal hypertension. A possible explanation for this new data that are in some contrast to previously published results is the degree of portal hypertension in our study, a comparatively short follow-up period, and well-defined investigation areas for spleen elastography in repetitive ARFI investigations. This trial is registered with NCT03315767.

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来源期刊
International Journal of Hepatology
International Journal of Hepatology GASTROENTEROLOGY & HEPATOLOGY-
CiteScore
3.80
自引率
0.00%
发文量
11
审稿时长
15 weeks
期刊介绍: International Journal of Hepatology is a peer-reviewed, Open Access journal that publishes original research articles, review articles, and clinical studies related to the medical, surgical, pathological, biochemical, and physiological aspects of hepatology, as well as the management of disorders affecting the liver, gallbladder, biliary tree, and pancreas.
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