| 1 | Controlled attenuation parameter for non-invasive assessment of hepatic steatosis in Chinese patients显示文摘AIM:To evaluate the performance of a novel non-invasive controlled attenuation parameter(CAP)to assess liver steatosis.METHODS:This was a multi-center prospective cohort study.Consecutive patients(aged≥18 years)who had undergone percutaneous liver biopsy and CAP measurement were recruited from three Chinese liver centers.Steatosis was categorized as S0:<5%;S1:5%-33%;S2:34%-66%;or S3:≥67%,according to the nonalcoholic fatty liver disease(NAFLD)activity score.The FibroScan?502 equipped with the M probe(Echosens,Paris,France)was used to capture both CAP and liver stiffness measurement values simultaneously.Receiver operating characteristic curves were plotted,and the areas under the curves were calculated to determine the diagnostic efficacy.The accuracy of the CAP values at the optimal thresholds was defined by maximizing the sum of sensitivity and specificity(maximum Youden index).RESULTS:A total of 152 patients were recruited,including 52(34.2%)patients with NAFLD and 100(65.8%)with chronic hepatitis B(CHB)virus infection.After adjustment,the steatosis grade(OR=37.12;95%CI:21.63-52.60,P<0.001)and body mass index(BMI,OR=6.20;95%CI:2.92-9.48,P<0.001)were found independently associated with CAP by multivariate linear regression analysis.CAP was not influenced by inflammation,fibrosis or aetiology.The median CAP values and interquartile ranges among patients with S0,S1,S2 and S3 steatosis were 211(181-240)dB/m,270(253-305)dB/m,330(302-360)dB/m,and 346(313-363)dB/m,respectively.The cut-offs for the CAP values in all patients with steatosis≥5%,≥34%and≥67%were 253 dB/m,285 dB/m and 310 dB/m,respectively.The areas under the curves were 0.92,0.92and 0.88 for steatosis≥5%,≥34%and≥67%,respectively.No significant differences were found in the CAP values between the NAFLD group and the CHB group in each steatosis grade.CONCLUSION:CAP appears to be a promising tool for the non-invasive detection and quantification of hepatic steatosis,but is limited by BMI. | Feng Shen Rui-Dan Zheng Yu-Qiang Mi Xiao-Ying Wang Qin Pan Guang-Yu Chen Hai-Xia Cao Ming-Li Chen Liang Xu Jian-Neng Chen Yi Cao Rui-Nan Zhang Lei-Ming Xu Jian-Gao Fan | 2014 | World Journal of Gastroenterology2014，20，16： | 55 |
| 2 | Noninvasive assessment of liver fibrosis in patients with chronic hepatitis B显示文摘Infection with hepatitis B virus is an important healthproblem worldwide:it affects more than 350 millionpeople and is a leading cause of liver-related morbidity,accounting for 1 million deaths annually.Hepatic fibrosis is a consequence of the accumulation of extracellular matrix components in the liver.An accurate diagnosis of liver fibrosis is essential for the management of chronic liver disease.Liver biopsy has been considered the gold standard for diagnosing disease,grading necroinflammatory activity,and staging fibrosis.However,liver biopsy is unsuitable for repeated evaluations because it is invasive and can cause major complications,including death.Several noninvasive evaluations have been introduced for the assessment of liver fibrosis:serum biomarkers,combined indices or scores,and imaging techniques including transient elastography,acoustic radiation force impulse,real-time tissue elastography,and magnetic resonance elastography.Here,we review the recent progress of noninvasive assessment of liver fibrosis in patients with chronic hepatitis B.Most noninvasive evaluations for liver fibrosis have been validated first in patients with chronic hepatitis C,and later in those with chronic hepatitis B.The establishment of a noninvasive assessment of liver fibrosis is urgently needed to aid in the management of this leading cause of chronic liver disease. | Masaru Enomoto Hiroyasu Morikawa Akihiro Tamori Norifumi Kawada | 2014 | World Journal of Gastroenterology2014，20，34： | 16 |
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