Araştırma Makalesi
Yıl 2024,
Cilt: 34 Sayı: 1, 65 - 70, 29.02.2024
Öz
Amaç: Çalışmamızda ultrason shear wave elastografi (SWE) değerleri ile histopatolojik sonuçlar arasındaki ilişkiyi inceledik. Böylece, SWE'nin erken fibrozu göstermedeki duyarlılığını değerlendirdik.
Materyal ve Metod: Kronik hepatit B hastalığına sahip ardışık 70 hasta prospektif olarak değerlendirildi. Ishak skorlamasına göre fibroz evreleri (F) 0, 1, 2, 3 ve 4'e dahil edilen hastalar SWE ile incelendi. Erken evre fibroz tespit edilen F2, F3 ve F4 hastalarının SWE ölçümleri, tedavi gerektirmeyen F0 ve F1 hastalarının ölçümleri ile karşılaştırıldı.
Bulgular: Tedavi gerektiren grup (F2, F3 ve F4) içindeki hız+SD ve kPa+SD değerleri, tedavi gerektirmeyen grup (F0 ve F1) içindeki değerlere göre anlamlı şekilde yüksekti (p < 0.05). Hız+SD için 1.85 kesme değerinin duyarlılık oranı %53.8, pozitif tahmin oranı %80.8, özgüllük oranı %83.3 ve negatif tahmin oranı %58.1 olarak bulundu. kPa+SD için, 10.8 kesme değeri duyarlılık oranı %51.3, pozitif tahmin oranı %95.2, özgüllük oranı %96.7 ve negatif tahmin oranı %60.4 olarak saptandı. Fibroz skoru ile kPa+SD dağılımı arasında anlamlı bir korelasyon gözlendi.
Sonuç: KDE, tedavi gerektiren hastaları (F2, F3 ve F4) tedavi gerektirmeyen hastalardan ayırt edebilir.
Anahtar Kelimeler
Kaynakça
- Smith A, Baumgartner K, Bositis C. Cirrhosis: Diagnosis and Management. Am Fam Physician. 2019; 100(12):759-770. PMID: 31845776.
- Söğütçü, N, Şafak K. "Kronik Hepatit B Hastalarında Karaciğer Biyopsi Sonuçlarının Değerlendirilmesi." Van Tıp Dergisi 2020; 27.4: 403-406.
- McGill DB, Rakela J, Zinsmeister AR, Ott BJ. A 21-year experience withmajor hemorrhage after percutaneous liver biopsy. Gastroenterology 1990;99:1396-1400.
- Gersak MM, Lupșor-Platon M, Badea R, Ciurea A, Dudea SM. Strain Elastography (SE) for liver fibrosis estimation - which elastic score to calculate? Med Ultrason. 2016 Dec 5;18(4):481-487.
- Pohl A, Behling C, Oliver D, Kilani M, Monson P, Hassanein T. Serumaminotransferase levels and platelet counts as predictors of degree of fibro-sis in chronic hepatitis C virus infection. Am J Gastroenterol 2001;96:3142-3146.
- Durmaz MS, Arslan S, Özbakır B, Güngör G, Tolu İ, Arslan FZ, Sivri M, Koplay M. Effectiveness of Shear Wave Elastography in the diagnosis of acute pancreatitis on admission. Med Ultrason. 2018 Aug 30;20(3):278-284.
- Felicani C, De Molo C, Stefanescu H, Conti F, Mazzotta E, Gabusi V, Nardi E, Morselli-Labate AM, Andreone P, Serra C. Point quantification elastography in the evaluation of liver elasticity in healthy volunteers: a reliability study based on operator expertise. J Ultrasound. 2018 Jun;21(2):89-98.
- Ziol M, Handra-Luca A, Kettaneh A, Christidis C, Mal F, Kazemi F, de Lédinghen V, Marcellin P, Dhumeaux D, Trinchet JC, Beaugrand M. Noninvasive assessment of liver fibrosis by measurement of stiffness in patients with chronic hepatitis C. Hepatology. 2005 Jan;41(1):48-54.
- Ishak K, Baptista A, Bianchi L, Callea F, De Groote J, Gudat F, Denk H, Desmet V, Korb G, MacSween RN, Phillipsk MJ, Portmannl BG, Poulsenm H, Scheuer PJ, Schmidn M, Thalero H (1995) Histological grading and staging of chronic hepatitis. J Hepatol 22:696–699.
- Herrmann E, de Lédinghen V, Cassinotto C,et al. Assessment of biopsy-proven liver fibrosis by two-dimensional shear wave elastography: An individual patient data-based meta-analysis. Hepatology. 2018 Jan;67(1):260-272.
- Tutar O, Beşer ÖF, Adaletli I, Tunc N, Gulcu D, Kantarci F, Mihmanli I, Cokugras FC, Kutlu T, Ozbay G, Erkan T. Shear wave elastography in the evaluation of liver fibrosis in children. J Pediatr Gastroenterol Nutr. 2014 Jun;58(6):750-5.
- Özbek SS. Karaciğer Elastografisi. 2019: Trd Sem.
- Wright M, Goldin R, Fabre A, et al. Measurement and determinants of the natural history of liver fibrosis in hepatitis C virus infection: a cross sectional and longitudinal study. Gut. 2003 Apr;52(4):574-9.
- Sun Y, Zhou J, Wu X, et al. Quantitative assessment of liver fibrosis (qFibrosis) reveals precise outcomes in Ishak "stable" patients on anti-HBV therapy. Sci Rep. 2018 Feb 14;8(1):2989.
- Ferraioli G, Tinelli C, Dal Bello B, Zicchetti M, Filice G, Filice C; Liver Fibrosis Study Group. Accuracy of real-time shear wave elastography for assessing liver fibrosis in chronic hepatitis C: a pilot study. Hepatology. 2012 Dec;56(6):2125-33.
- Guibal A, Renosi G, Rode A, Scoazec JY, Guillaud O, Chardon L, Munteanu M, Dumortier J, Collin F, Lefort T. Shear wave elastography: An accurate technique to stage liver fibrosis in chronic liver diseases. Diagn Interv Imaging. 2016 Jan;97(1):91-9.
- Samir AE, Dhyani M, Vij A, Bhan AK, Halpern EF, Méndez-Navarro J, Corey KE, Chung RT. Shear-wave elastography for the estimation of liver fibrosis in chronic liver disease: determining accuracy and ideal site for measurement. Radiology. 2015 Mar;274(3):888-96.
- Sporea I, Bota S, Gradinaru-Taşcău O, Sirli R, Popescu A, Jurchiş A. Which are the cut-off values of 2D-Shear Wave Elastography (2D-SWE) liver stiffness measurements predicting different stages of liver fibrosis, considering Transient Elastography (TE) as the reference method? Eur J Radiol. 2014 Mar;83(3):e118-22.
- Ma JJ, Ding H, Mao F, Sun HC, Xu C, Wang WP. Assessment of liver fibrosis with elastography point quantification technique in chronic hepatitis B virus patients: a comparison with liver pathological results. J Gastroenterol Hepatol. 2014 Apr;29(4):814-9.
- Ogawa E, Furusyo N, Toyoda K, Takeoka H, Otaguro S, Hamada M, Murata M, Sawayama Y, Hayashi J. Transient elastography for patients with chronic hepatitis B and C virus infection: Non-invasive, quantitative assessment of liver fibrosis. Hepatol Res. 2007 Dec;37(12):1002-10.
- Chon YE, Park JY, Myoung SM, Jung KS, Kim BK, Kim SU, Kim DY, Ahn SH, Han KH. Improvement of Liver Fibrosis after Long-Term Antiviral Therapy Assessed by Fibroscan in Chronic Hepatitis B Patients With Advanced Fibrosis. Am J Gastroenterol. 2017 Jun;112(6):882-891.
- Vergniol J, Boursier J, Coutzac C, Bertrais S, Foucher J, Angel C, Chermak F, Hubert IF, Merrouche W, Oberti F, de Lédinghen V, Calès P. Evolution of noninvasive tests of liver fibrosis is associated with prognosis in patients with chronic hepatitis C. Hepatology. 2014 Jul;60(1):65-76.
- Sande JA, Verjee S, Vinayak S, Amersi F, Ghesani M. Ultrasound shear wave elastography and liver fibrosis: A Prospective Multicenter Study. World J Hepatol. 2017 Jan 8;9(1):38-47.
Yıl 2024,
Cilt: 34 Sayı: 1, 65 - 70, 29.02.2024
Öz
Aim: We examined the relationship between shear wave elastography (SWE) values and histopathological results in our study. Thus, we found the sensitivity of SWE in demonstrating early fibrosis.
Materials and Methods: A total of consecutive 70 patients with chronic hepatitis B were prospectively evaluated. The patients included in fibrosis stages (F) 0, 1, 2, 3 and 4 according to Ishak scoring were examined with SWE. SWE measurements of F2, F3 and F4 patients who were found to have early stage fibrosis were compared with those of F0 and F1 patients.
Results: The velocity+SD, and kPa+SD values in the group requiring treatment (F2, F3 and F4) were significantly higher than the group not requiring treatment (F0 and F1 )(p < 0.05). The sensitivity rate of the 1.85 cut-off value for velocity+SD was 53.8%, the positive prediction rate was 80.8%, the specificity rate was 83.3%, and the negative prediction rate was 58.1%. For kPa+SD, the cut-off value of 10.8 had a sensitivity rate of 51.3%, a positive prediction rate of 95.2%, a specificity of 96.7%, and a negative predictive rate of 60.4%. A significant correlation was observed between the fibrosis score and the kPa+SD distribution.
Conclusion: SWE can differentiate the patients requiring treatment (F2, F3 and F4) from the patients not requiring treatment.
Anahtar Kelimeler
Kaynakça
- Smith A, Baumgartner K, Bositis C. Cirrhosis: Diagnosis and Management. Am Fam Physician. 2019; 100(12):759-770. PMID: 31845776.
- Söğütçü, N, Şafak K. "Kronik Hepatit B Hastalarında Karaciğer Biyopsi Sonuçlarının Değerlendirilmesi." Van Tıp Dergisi 2020; 27.4: 403-406.
- McGill DB, Rakela J, Zinsmeister AR, Ott BJ. A 21-year experience withmajor hemorrhage after percutaneous liver biopsy. Gastroenterology 1990;99:1396-1400.
- Gersak MM, Lupșor-Platon M, Badea R, Ciurea A, Dudea SM. Strain Elastography (SE) for liver fibrosis estimation - which elastic score to calculate? Med Ultrason. 2016 Dec 5;18(4):481-487.
- Pohl A, Behling C, Oliver D, Kilani M, Monson P, Hassanein T. Serumaminotransferase levels and platelet counts as predictors of degree of fibro-sis in chronic hepatitis C virus infection. Am J Gastroenterol 2001;96:3142-3146.
- Durmaz MS, Arslan S, Özbakır B, Güngör G, Tolu İ, Arslan FZ, Sivri M, Koplay M. Effectiveness of Shear Wave Elastography in the diagnosis of acute pancreatitis on admission. Med Ultrason. 2018 Aug 30;20(3):278-284.
- Felicani C, De Molo C, Stefanescu H, Conti F, Mazzotta E, Gabusi V, Nardi E, Morselli-Labate AM, Andreone P, Serra C. Point quantification elastography in the evaluation of liver elasticity in healthy volunteers: a reliability study based on operator expertise. J Ultrasound. 2018 Jun;21(2):89-98.
- Ziol M, Handra-Luca A, Kettaneh A, Christidis C, Mal F, Kazemi F, de Lédinghen V, Marcellin P, Dhumeaux D, Trinchet JC, Beaugrand M. Noninvasive assessment of liver fibrosis by measurement of stiffness in patients with chronic hepatitis C. Hepatology. 2005 Jan;41(1):48-54.
- Ishak K, Baptista A, Bianchi L, Callea F, De Groote J, Gudat F, Denk H, Desmet V, Korb G, MacSween RN, Phillipsk MJ, Portmannl BG, Poulsenm H, Scheuer PJ, Schmidn M, Thalero H (1995) Histological grading and staging of chronic hepatitis. J Hepatol 22:696–699.
- Herrmann E, de Lédinghen V, Cassinotto C,et al. Assessment of biopsy-proven liver fibrosis by two-dimensional shear wave elastography: An individual patient data-based meta-analysis. Hepatology. 2018 Jan;67(1):260-272.
- Tutar O, Beşer ÖF, Adaletli I, Tunc N, Gulcu D, Kantarci F, Mihmanli I, Cokugras FC, Kutlu T, Ozbay G, Erkan T. Shear wave elastography in the evaluation of liver fibrosis in children. J Pediatr Gastroenterol Nutr. 2014 Jun;58(6):750-5.
- Özbek SS. Karaciğer Elastografisi. 2019: Trd Sem.
- Wright M, Goldin R, Fabre A, et al. Measurement and determinants of the natural history of liver fibrosis in hepatitis C virus infection: a cross sectional and longitudinal study. Gut. 2003 Apr;52(4):574-9.
- Sun Y, Zhou J, Wu X, et al. Quantitative assessment of liver fibrosis (qFibrosis) reveals precise outcomes in Ishak "stable" patients on anti-HBV therapy. Sci Rep. 2018 Feb 14;8(1):2989.
- Ferraioli G, Tinelli C, Dal Bello B, Zicchetti M, Filice G, Filice C; Liver Fibrosis Study Group. Accuracy of real-time shear wave elastography for assessing liver fibrosis in chronic hepatitis C: a pilot study. Hepatology. 2012 Dec;56(6):2125-33.
- Guibal A, Renosi G, Rode A, Scoazec JY, Guillaud O, Chardon L, Munteanu M, Dumortier J, Collin F, Lefort T. Shear wave elastography: An accurate technique to stage liver fibrosis in chronic liver diseases. Diagn Interv Imaging. 2016 Jan;97(1):91-9.
- Samir AE, Dhyani M, Vij A, Bhan AK, Halpern EF, Méndez-Navarro J, Corey KE, Chung RT. Shear-wave elastography for the estimation of liver fibrosis in chronic liver disease: determining accuracy and ideal site for measurement. Radiology. 2015 Mar;274(3):888-96.
- Sporea I, Bota S, Gradinaru-Taşcău O, Sirli R, Popescu A, Jurchiş A. Which are the cut-off values of 2D-Shear Wave Elastography (2D-SWE) liver stiffness measurements predicting different stages of liver fibrosis, considering Transient Elastography (TE) as the reference method? Eur J Radiol. 2014 Mar;83(3):e118-22.
- Ma JJ, Ding H, Mao F, Sun HC, Xu C, Wang WP. Assessment of liver fibrosis with elastography point quantification technique in chronic hepatitis B virus patients: a comparison with liver pathological results. J Gastroenterol Hepatol. 2014 Apr;29(4):814-9.
- Ogawa E, Furusyo N, Toyoda K, Takeoka H, Otaguro S, Hamada M, Murata M, Sawayama Y, Hayashi J. Transient elastography for patients with chronic hepatitis B and C virus infection: Non-invasive, quantitative assessment of liver fibrosis. Hepatol Res. 2007 Dec;37(12):1002-10.
- Chon YE, Park JY, Myoung SM, Jung KS, Kim BK, Kim SU, Kim DY, Ahn SH, Han KH. Improvement of Liver Fibrosis after Long-Term Antiviral Therapy Assessed by Fibroscan in Chronic Hepatitis B Patients With Advanced Fibrosis. Am J Gastroenterol. 2017 Jun;112(6):882-891.
- Vergniol J, Boursier J, Coutzac C, Bertrais S, Foucher J, Angel C, Chermak F, Hubert IF, Merrouche W, Oberti F, de Lédinghen V, Calès P. Evolution of noninvasive tests of liver fibrosis is associated with prognosis in patients with chronic hepatitis C. Hepatology. 2014 Jul;60(1):65-76.
- Sande JA, Verjee S, Vinayak S, Amersi F, Ghesani M. Ultrasound shear wave elastography and liver fibrosis: A Prospective Multicenter Study. World J Hepatol. 2017 Jan 8;9(1):38-47.
Toplam 23 adet kaynakça vardır.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Radyoloji ve Organ Görüntüleme |
| Bölüm | Original Article |
| Yazarlar | |
| Erken Görünüm Tarihi | 26 Şubat 2024 |
| Yayımlanma Tarihi | 29 Şubat 2024 |
| Gönderilme Tarihi | 21 Ağustos 2023 |
| Yayımlandığı Sayı | Yıl 2024 Cilt: 34 Sayı: 1 |
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