Gravity assistance enables liver stiffness measurements to detect liver fibrosis under congestive circumstances  

作　　者：Takeshi Suda Ai Sugimoto Tsutomu Kanefuji Atsushi Abe Takeshi Yokoo Takahiro Hoshi Satoshi Abe Shinichi Morita Kazuyoshi Yagi Masashi Takahashi Shuji Terai 

机构地区：[1]Department of Gastroenterology and Hepatology,Uonuma Institute of Community Medicine,Niigata University Medical and Dental Hospital,Minami Uonuma 949-7302,Niigata,Japan [2]Division of Thoracic and Cardiovascular Surgery,Graduate School of Medical and Dental Sciences,Niigata University,Niigata 951-8122,Japan [3]Department of Gastroenterology and Hepatology,Tsubame Rosai Hospital,Tsubame 959-1228,Niigata,Japan [4]Department of Administration,Joetsu-Area General Health Care Center,Joetsu 943-0803,Niigata,Japan [5]Department of Preemptive Medicine for Digestive Diseases and Healthy Active Life,Niigata University School of Medicine,Niigata 951-8122,Japan [6]Division of Gastroenterology and Hepatology,School of Medical and Dental Sciences,Niigata University,Niigata 951-8122,Japan

出　　处：《World Journal of Hepatology》2022年第4期778-790,共13页世界肝病学杂志（英文版）（电子版）

摘　　要：BACKGROUND As survival has been prolonged owing to surgical and medical improvements,liver failure has become a prognostic determinant in patients with congestive heart diseases.Congestive hepatopathy,an abnormal state of the liver as a result of congestion,insidiously proceed toward end-stage liver disease without effective biomarkers evaluating pathological progression.Regular measurements of shear wave elastography cannot qualify liver fibrosis,which is a prognosticator in any type of chronic liver disease,in cases of congestion because congestion makes the liver stiff without fibrosis.We hypothesized that the effects of congestion and fibrosis on liver stiffness can be dissociated by inducing architectural deformation of the liver to expose structural rigidity.To establish a strategy measuring liver stiffness as a reflection of architectural rigidity under congestion.METHODS Two-dimensional shear wave elastography(2dSWE)was measured in the supine(Sp)and left decubitus(Ld)positions in 298 consecutive cases as they were subjected to an ultrasound study for various liver diseases.Regions of interest were placed at twelve sites,and the median and robust coefficient of variation were calculated.Numerical data were compared using the Mann-Whitney U or Kruskal-Wallis test followed by Dunn's post-hoc multiple comparisons.The inferior vena cava(IVC)diameters at different body positions were compared using the Wilcoxon matched pairs signed rank test.The number of cases with cardiothoracic ratios greater than or not greater than 50%was compared using Fisher’s exact test.A correlation of 2dSWE between different body positions was evaluated by calculating Spearman correlation coefficients.RESULTS The IVC diameter was significantly reduced in Ld in subjects with higher 2dSWE values in Ld(LdSWE)than in Sp(SpSWE)(P=0.007,(average±SD)13.9±3.6 vs 13.1±3.4 mm)but not in those with lower LdSWE values(P=0.32,13.3±3.5 vs 13.0±3.5 mm).In 81 subjects,SpSWE was increased or decreased in Ld beyond the magnitude of robust coeffi

关 键 词：Shear wave elastography Inferior vena cava diameter Congestive hepatopathy Liver fibrosis Body positions Fibrosis-4 index 

分 类 号：R575.2[医药卫生—消化系统]