Περίληψη:
Background and aims: Liver stiffness measurements (LSMs) by 2-dimensional-shear-wave elastography (LSM2D-SWE) are now widely used in hepatology. However, relevant information for primary biliary cholangitis (PBC) is scant. We compare LSM2D-SWE with liver biopsy (LB) in a cohort of PBC patients in Greece. Methods: Data of 68 LBs from 53 PBC patients were retrospectively analyzed and fibrosis stage was compared to LSM2D-SWE. Forty-six patients (86.8%) were females and at the time of LBx median (IQR) age was 62.6 (53.2–72.1). Demographic, UDCA treatment, histological and B-mode ultrasound data were tested for their influence on LSM2D-SWE estimates. Results: Liver fibrosis stages F0–F4 were found in 4, 19, 19, 16 and 10 cases, respectively. Across stages F0–F4, the LSM2D-SWE was 5.6 (5.1–6.1), 7.0 (5.8–7.7), 9.1 (7.3–11.5), 10.8 (9.9–12.2) and 14.5 (11.9–25.7) kPa, respectively, with highly significant difference (p<.001). The LSM2D-SWE differed also significantly between F0 vs. F1 (p=.027), F1 vs. F2 (p=.005) and F3 vs. F4 (p=.017). The discriminatory ability of LSM2D-SWE for mild, significant, severe fibrosis and cirrhosis was highly significant in all comparisons (p<.001), with AUC2D-SWE 95.3%, 87.4%, 85.3% and 95.3% and accuracy 89.7%, 85.3%, 80.9% and 86.8%, respectively. Among 21 parameters tested, significant predictors of LSM2D-SWE by multiple linear regression were fibrosis stage, portal inflammation and parenchymal heterogeneity. The portal inflammation grade accounted for 32.2% of LSM variation with adjusted R 2 0.428. Conclusions: In patients with PBC, LSM measurements by 2D-SWE can reliably discriminate between mild, significant, severe fibrosis and cirrhosis. Measurements are significantly affected by portal inflammation grade. © 2021 Informa UK Limited, trading as Taylor & Francis Group.
Συγγραφείς:
Manesis, E.K.
Schina, M.
Vafiadis, I.
Gatos, I.
Theotokas, J.
Zoumpoulis, P.
Drazinos, P.
Ketikoglou, J.
Delladetsima, I.K.
Tiniakos, D.G.
Λέξεις-κλειδιά:
alanine aminotransferase; alkaline phosphatase; aspartate aminotransferase, adult; aged; alanine aminotransferase blood level; alkaline phosphatase blood level; Article; aspartate aminotransferase blood level; B scan; cohort analysis; controlled study; female; Greece; human; human tissue; inflammation; liver biopsy; liver cirrhosis; liver fibrosis; liver histology; liver stiffness; major clinical study; male; portal fibrosis; primary biliary cirrhosis; prognosis; retrospective study; right liver lobe; shear wave elastography; spleen size; splenomegaly; treatment response; two-dimensional imaging; biliary cirrhosis; diagnostic imaging; elastography, Elasticity Imaging Techniques; Female; Humans; Liver Cirrhosis; Liver Cirrhosis, Biliary; Retrospective Studies
