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| 1 | Real time shear wave elastography in chronic liver diseases:Accuracy for predicting liver fibrosis,in comparison with serum markers显示文摘AIM:To evaluate the correlation between liver stiffness measurement(LSM)by real-time shear wave elastography(SWE)and liver fibrosis stage and the accuracy of LSM for predicting significant and advanced fibrosis,in comparison with serum markers.METHODS:We consecutively analyzed 70 patients with various chronic liver diseases.Liver fibrosis was staged from F0 to F4 according to the Batts and Ludwig scoring system.Significant and advanced fibrosis was defined as stage F≥2 and F≥3,respectively.The accuracy of prediction for fibrosis was analyzed using receiver operating characteristic curves.RESULTS:Seventy patients,15 were belonged to F0-F1 stage,20 F2,13 F3 and 22 F4.LSM was increased with progression of fibrosis stage(F0-F1:6.77±1.72,F2:9.98±3.99,F3:15.80±7.73,and F4:22.09±10.09,P<0.001).Diagnostic accuracies of LSM for prediction of F≥2 and F≥3 were 0.915(95%CI:0.824-0.968,P<0.001)and 0.913(95%CI:0.821-0.967,P<0.001),respectively.The cut-off values of LSM for prediction of F≥2 and F≥3 were 8.6kPa with 78.2%sensitivity and 93.3%specificity and10.46 kPa with 88.6%sensitivity and 80.0%specificity,respectively.However,there were no significant differences between LSM and serum hyaluronic acid and typeⅣcollagen in diagnostic accuracy.CONCLUSION:SWE showed a significant correlation with the severity of liver fibrosis and was useful and accurate to predict significant and advanced fibrosis,comparable with serum markers. | Jae Yoon Jeong Tae Yeob Kim Joo Hyun Sohn Yongsoo Kim Woo Kyoung Jeong Young-Ha Oh Kyo-Sang Yoo | 2014 | World Journal of Gastroenterology2014，20，38： | 19 |
| 2 | Combined acoustic radiation force impulse, aminotransferase to platelet ratio index and Forns index assessment for hepatic fibrosis grading in hepatitis B显示文摘AIM: To investigate the combined diagnostic accuracy of acoustic radiation force impulse(ARFI), aspartate aminotransferase to platelet ratio index(APRI) and Forns index for a non-invasive assessment of liver fibrosis in patients with chronic hepatitis B(CHB). METHODS: In this prospective study, 206 patients had CHB with liver fibrosis stages F0-F4 classified by METAVIR and 40 were healthy volunteers were measured by ARFI, APRI and Forns index separately or combined as indicated. RESULTS: ARFI, APRI or Forns index demonstrated a significant correlation with the histological stage(all P < 0.001). According to the AUROC of ARFI and APRI for evaluating fibrotic stages more than F2, ARFI showed an enhanced diagnostic accuracy than APRI(P < 0.05). The combined measurement of ARFI and APRI exhibited better accuracy than ARFI alone when evaluating ≥ F2 fibrotic stage(Z = 2.77, P = 0.006). Combination of ARFI, APRI and Forns index did not obviously improve the diagnostic accuracy compared to the combination of ARFI and APRI(Z = 0.958, P = 0.338). CONCLUSION: ARFI + APRI showed enhanced diagnostic accuracy than ARFI or APRI alone for significant liver fibrosis and ARFI + APRI + Forns index shows the same effect with ARFI + APRI. | Chang-Feng Dong Jia Xiao Ling-Bo Shan Han-Ying Li Yong-Jia Xiong Gui-Lin Yang Jing Liu Si-Min Yao Sha-Xi Li Xiao-Hua Le Jing Yuan Bo-Ping Zhou George L Tipoe Ying-Xia Liu | 2016 | World Journal of Hepatology2016，8，14： | 18 |
| 3 | Transient elastography improves detection of liver cirrhosis compared to routine screening tests显示文摘AIM:To investigate the diagnostic significance oftransient elastography(TE) in a daily routine clinical setting in comparison to clinical signs,laboratory parameters and ultrasound.METHODS:TE,ultrasound,laboratory parameters and cutaneous liver signs were assessed in 291 consecutive patients with chronic liver disease of various aetiologies who underwent liver biopsy in daily routine.RESULTS:Sensitivity of TE for the detection of liver cirrhosis was 90.4%,compared to 80.1% for ultrasound,58.0% for platelet count and 45.1% for cutaneous liver signs(P < 0.0001 for comparisons with histology).AUROC for TE was 0.760(95%CI:0.694-0.825).Combination of TE with ultrasound increased sensitivity to 96.1% and AUROC to 0.825(95%CI:0.768-0.882).TE correlated with laboratory parameters of cirrhosis progression like albumin(r =-0.43),prothrombin time(r =-0.44),and bilirubin(r = 0.34; P < 0.001 for each).Particularly,in patients with Child Pugh score A or normal platelet count TE improved sensitivity for the detection of liver cirrhosis compared to ultrasound by 14.1%(P < 0.04) and 16.3%(P < 0.02),respectively.CONCLUSION:Transient elastography is superior to routine diagnostic tests allowing detection of liver cirrhosis in additional 10%-16% of patients with chronic liver disease that would have been missed by clinical examinations. | Thomas Gobel Janine Schadewaldt-Tümmers Lucas Greiner Christopher Poremba Dieter Haussinger Andreas Erhardt | 2015 | World Journal of Gastroenterology2015，21，3： | 8 |
| 4 | General review of magnetic resonance elastography显示文摘Magnetic resonance elastography(MRE) is an innovative imaging technique for the non-invasive quantification of the biomechanical properties of soft tissues via the direct visualization of propagating shear waves in vivo using a modified phase-contrast magnetic resonance imaging(MRI) sequence. Fundamentally,MRE employs the same physical property that physicians utilize when performing manual palpation- that healthy and diseased tissues can be differentiated on the basis of widely differing mechanical stiffness. By performing 'virtual palpation ',MRE is able to provide information that is beyond the capabilities of conventional morphologic imaging modalities. In an era of increasing adoption of multi-parametric imaging approaches for solving complex problems,MRE can be seamlessly incorporated into a standard MRI examination to provide a rapid,reliable and comprehensive imaging evaluation at a single patient appointment. Originally described by the Mayo Clinic in 1995,the technique represents the most accurate non-invasive method for the detection and staging of liver fibrosis and is currently performed in more than 100 centers worldwide. In this general review,the mechanical properties of soft tissues,principles of MRE,clinical applications of MRE in the liver and beyond,and limitations and future directions of this discipline-are discussed. Selected diagrams and images are provided for illustration. | Gavin Low Scott A Kruse David J Lomas | 2016 | World Journal of Radiology2016，8，1： | 5 |
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