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Wang J, Hu M, Zhu Q, Sun L. Liver stiffness assessed by real-time two-dimensional shear wave elastography predicts hypersplenism in patients with Wilson's disease: a prospective study. BMC Med Imaging 2022; 22:25. [PMID: 35148699 PMCID: PMC8832652 DOI: 10.1186/s12880-022-00749-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 01/26/2022] [Indexed: 12/12/2022] Open
Abstract
Background The current study aimed to explore the value of liver stiffness assessed by two-dimensional real-time shear wave elastography (2D-SWE) to predict hypersplenism occurrence in Wilson’s disease (WD) patients. Methods Ninety WD patients were enrolled in this prospective study between May 2018 and December 2018. Baseline clinical data and ultrasound imaging including 2D-SWE liver stiffness of WD patients were collected. After enrollment, patients had follow-ups for 24 months or until they developed hypersplenism. The hypersplenism risk factors were determined using Cox regressions and receiver operating characteristic curves (ROC). Results Twenty-nine (32.2%) patients developed hypersplenism. Age, portal vein diameter, and liver stiffness were independent hypersplenism risk factors in WD patients. The cutoff value of liver stiffness to predict hypersplenism was 10.45 kPa, with sensitivity and specificity of 75.9% and 73.8%, respectively. Patients were divided into two groups according to liver stiffness: ≥ 10.45 kPa (57.9% with hypersplenism) or < 10.45 kPa (13.5% with hypersplenism). The median time between enrollment and hypersplenism development was 15 months vs. 22 months (p < 0.001) for the two groups, respectively. Conclusion The measurement of liver stiffness by 2D-SWE can be a reliable hypersplenism predictor in WD patients. Therefore, dynamic monitoring of WD patients using 2D-SWE is crucial for the early diagnosis of hypersplenism.
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Affiliation(s)
- Jiajia Wang
- Department of Diagnostic Ultrasound, Beijing Tongren Hospital, Capital Medical University, No. 1, Dong Jiao Min Xiang Street, Dongcheng District, Beijing, 100730, China.,Department of Ultrasound, The First Affiliated Hospital of Anhui University of Chinese Medicine, Hefei, China
| | - Minxia Hu
- Department of Diagnostic Ultrasound, Beijing Tongren Hospital, Capital Medical University, No. 1, Dong Jiao Min Xiang Street, Dongcheng District, Beijing, 100730, China
| | - Qiang Zhu
- Department of Diagnostic Ultrasound, Beijing Tongren Hospital, Capital Medical University, No. 1, Dong Jiao Min Xiang Street, Dongcheng District, Beijing, 100730, China.
| | - Lanting Sun
- Department of Encephalopathy, The First Affiliated Hospital of Anhui University of Chinese Medicine, Hefei, China
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Zhang T, Zhang G, Deng X, Zeng J, Jin J, Zeping H, Wu M, Zheng R. APS (Age, Platelets, 2D Shear-Wave Elastography) Score Predicts Hepatocellular Carcinoma in Chronic Hepatitis B. Radiology 2021; 301:350-359. [PMID: 34427463 DOI: 10.1148/radiol.2021204700] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Background Two-dimensional (2D) shear-wave elastography (SWE) has been considered to be useful in predicting hepatocellular carcinoma (HCC) development in patients with chronic hepatitis B (CHB). Purpose To develop a risk model using 2D SWE to predict HCC in patients with CHB and to compare its predictive value with that of other models. Materials and Methods Patients with biopsy-proven CHB who underwent US and 2D SWE between April 2011 and December 2015 were enrolled in this study. After 2D SWE and biopsy were performed, the patients received regular follow-up for the detection of HCC. The scoring system was developed by dividing the parameters of the Cox proportional hazards model by the smallest parameter and simplifying the assigned points to integers. The predictive performance of the new score was compared with that of other scores. Results Among the 654 patients (mean age, 37 years; range, 30-43 years; 510 men), 26 developed HCC. The variables of age, platelet count, and liver stiffness measurement at 2D SWE were weighted to develop the so-called APS score, with a cutoff of 60 showing the best discrimination for HCC risk. The APS score (area under the receiver operating characteristic curve [AUC], 0.89) was superior to that of the Chinese University HCC prediction score constructed from age, albumin level, bilirubin level, hepatitis B virus (HBV) DNA level, and cirrhosis (AUC, 0.70; P = .005) and slightly higher than that of the guide with age, gender, HBV DNA level, core promoter mutations, and cirrhosis, or GAG-HCC score (AUC, 0.82; P = .052). In patients who underwent transient elastography, the AUC of the APS score was 0.79, compared with 0.82 for the modified risk estimation for HCC in CHB, or mREACH-B, score (P = .05). The APS score performed better in patients regardless of whether antiviral treatment was used, inflammation grade was low or high, or alanine aminotransferase levels were normal or high (all P > .05). Conclusion The APS score based on only the patient's baseline liver stiffness measurement at two-dimensional shear-wave elastography, age, and platelet count is valuable for predicting hepatocellular carcinoma in patients with chronic hepatitis B. © RSNA, 2021 Online supplemental material is available for this article.
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Affiliation(s)
- Ting Zhang
- From the Departments of Medical Ultrasonics (T.Z., J.Z., J.J., Z.H., M.W., R.Z.) and Infectious Disease (G.Z.), Third Affiliated Hospital of Sun Yat-Sen University, 600 TianHe Rd, Guangzhou 510630, China; and Department of Environmental Health Sciences, University at Albany, State University of New York, Rensselaer, NY (X.D.)
| | - Genglin Zhang
- From the Departments of Medical Ultrasonics (T.Z., J.Z., J.J., Z.H., M.W., R.Z.) and Infectious Disease (G.Z.), Third Affiliated Hospital of Sun Yat-Sen University, 600 TianHe Rd, Guangzhou 510630, China; and Department of Environmental Health Sciences, University at Albany, State University of New York, Rensselaer, NY (X.D.)
| | - Xinlei Deng
- From the Departments of Medical Ultrasonics (T.Z., J.Z., J.J., Z.H., M.W., R.Z.) and Infectious Disease (G.Z.), Third Affiliated Hospital of Sun Yat-Sen University, 600 TianHe Rd, Guangzhou 510630, China; and Department of Environmental Health Sciences, University at Albany, State University of New York, Rensselaer, NY (X.D.)
| | - Jie Zeng
- From the Departments of Medical Ultrasonics (T.Z., J.Z., J.J., Z.H., M.W., R.Z.) and Infectious Disease (G.Z.), Third Affiliated Hospital of Sun Yat-Sen University, 600 TianHe Rd, Guangzhou 510630, China; and Department of Environmental Health Sciences, University at Albany, State University of New York, Rensselaer, NY (X.D.)
| | - Jieyang Jin
- From the Departments of Medical Ultrasonics (T.Z., J.Z., J.J., Z.H., M.W., R.Z.) and Infectious Disease (G.Z.), Third Affiliated Hospital of Sun Yat-Sen University, 600 TianHe Rd, Guangzhou 510630, China; and Department of Environmental Health Sciences, University at Albany, State University of New York, Rensselaer, NY (X.D.)
| | - Huang Zeping
- From the Departments of Medical Ultrasonics (T.Z., J.Z., J.J., Z.H., M.W., R.Z.) and Infectious Disease (G.Z.), Third Affiliated Hospital of Sun Yat-Sen University, 600 TianHe Rd, Guangzhou 510630, China; and Department of Environmental Health Sciences, University at Albany, State University of New York, Rensselaer, NY (X.D.)
| | - Manli Wu
- From the Departments of Medical Ultrasonics (T.Z., J.Z., J.J., Z.H., M.W., R.Z.) and Infectious Disease (G.Z.), Third Affiliated Hospital of Sun Yat-Sen University, 600 TianHe Rd, Guangzhou 510630, China; and Department of Environmental Health Sciences, University at Albany, State University of New York, Rensselaer, NY (X.D.)
| | - Rongqin Zheng
- From the Departments of Medical Ultrasonics (T.Z., J.Z., J.J., Z.H., M.W., R.Z.) and Infectious Disease (G.Z.), Third Affiliated Hospital of Sun Yat-Sen University, 600 TianHe Rd, Guangzhou 510630, China; and Department of Environmental Health Sciences, University at Albany, State University of New York, Rensselaer, NY (X.D.)
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Jeong JY, Cho YS, Sohn JH. Role of two-dimensional shear wave elastography in chronic liver diseases: A narrative review. World J Gastroenterol 2018; 24:3849-3860. [PMID: 30228779 PMCID: PMC6141332 DOI: 10.3748/wjg.v24.i34.3849] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Revised: 07/18/2018] [Accepted: 07/21/2018] [Indexed: 02/06/2023] Open
Abstract
Liver biopsy is the gold standard for evaluating the degree of liver fibrosis in patients with chronic liver disease. However, due to the many limitations of liver biopsy, there has been much interest in the use of noninvasive techniques for this purpose. Among these techniques real-time two-dimensional shear wave elastography (2D-SWE) has the advantage of measuring tissue elasticity with the guidance of B-mode images. Recently, many studies have been conducted on the application of 2D-SWE in patients with various liver diseases, and their validity has been confirmed. Here, we briefly discuss the role of 2D-SWE in patients with chronic liver diseases, particularly aspects of the examination techniques and clinical applications.
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Affiliation(s)
- Jae Yoon Jeong
- Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri 11923, South Korea
| | - Young Seo Cho
- Department of Radiology, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri 11923, South Korea
| | - Joo Hyun Sohn
- Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri 11923, South Korea
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