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Radiology:影响肝纤维化评价和稳定性的指标

2018-04-14 shaosai MedSci原创

本研究旨在确认利用点横波弹性成像(pSWE)非侵入性评价肝纤维化需要评价的最少数目,验证是否可靠性指标如四分位数间距(IQR)与中位数比率会影响诊断效能,并将结果发表在Radiology上。

本研究旨在确认利用点横波弹性成像(pSWE)非侵入性评价肝纤维化需要评价的最少数目,验证是否可靠性指标如四分位数间距(IQR)与中位数比率会影响诊断效能,并将结果发表在Radiology上。

本研究共纳入了232例受试者,并行pSWE及10个横波流速评价。计算最初2个中位数间与9个评价指标与整体10个评价指标的组间相关因子(ICC);确定ICC超过0.95的最小评价数量与整体10个评价标准。在利用ROC曲线比较鉴别显着性纤维化(Ishak stage, ≥3)、严重纤维化和肝硬化(Ishak stage, ≥5)最小评价指标数量与整体10个评价指标的诊断能力。比较指标间可靠性能力(IQR与中位数比值≤ 30%和IQR与中位数比值>30%)。

结果为,与10个指标相比,最少需要6分SWV进行评价。根据评价指标的数量(6vs 10),诊断显着性(AUC:0.828 vs 0.839; P = .487)、严重纤维化或肝硬化(0.953 vs 0.969; P = .145)间无显着性差异,以6个诊断指标进行评价仅会导致少数与组织学结果不相符(9/232 [3.9%])。当使用10个诊断指标是,与可靠性低的指标(26 [31.7%]和8[9.8%] /82 例)相比,利用10个评价质指标(22 [14.7%]和[2.0%]/150例,)在pSWE与显着性、严重纤维化或肝硬化间有较高的可靠性。显着性肝纤维化是低可靠性的独立预测因子(HRo, 2.22; P < .020)。

本研究表明,利用pSWE评价肝纤维化可以采用较为少数的SWV评价指标(中位数6vs中位数10).评价指标的数量对诊断准确率较低可靠性指标影响较小。

原始出处:


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    2018-04-16 huagfeg
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    2018-04-15 wzb521zf

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