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用于预测高风险食道的100赫兹过渡弹性图的诊断准确性
Jain Harsh Prakash1, Prajna Anirvan2, Shubham Gupta1
1Department of Gastroenterology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India, 751019.
The American journal of gastroenterology
|August 22, 2025
概括
硬度测量 (SSM) 可以准确预测肝硬化患者的高风险食道静脉瘤 (HREV). 将SSM与肝硬度测量 (LSM) 和血小板计数 (PC) 结合起来,可以准确预测临床显著的门高血压 (CSPH),减少不必要的内镜检查.
科学领域:
- 肝病学
- 胃肠病学
- 医学成像
背景情况:
- 巴文诺VII指南提出了预测肝硬化时HREV和CSPH的SSM截止值.
- 使用脏专用100 Hz TE验证这些切断值是有限的.
- 这项研究评估了SSM对HREV和CSPH预测的诊断性能.
研究的目的:
- 评估硬度测量 (SSM) 的诊断性能,以预测肝硬化患者的高风险食道静脉瘤 (HREV) 和临床显著的门脉高血压 (CSPH).
- 将SSM与现有的非侵入性算法和Baveno VII标准进行比较.
- 为了排除HREV,推导和验证新的SSM截止值.
主要方法:
- 这是一项针对116名肝硬化患者的前性单中心研究.
- 使用脏专用100赫兹TE,实验室测试和内镜.
- 导出了一个新的SSM切断点,并将其性能与已有的算法和Baveno VII标准进行了比较.
主要成果:
- 在HREV预测方面,SSM的诊断准确度很高 (AUROC为0.849).
- 在补偿性肝硬化中,新的SSM切断值为35kPa,其灵敏度为95. 6%.
- 与Baveno VII标准相比,单独使用SSM可以避免更多的内镜 (44. 8%) 和较低的HREV遗漏率 (6. 1%).
结论:
- SSM是一种可靠的非侵入性工具,用于预测肝硬化时的HREV.
- 将SSM与LSM和PC相结合可以准确预测CSPH,从而可能减少内镜手术.
- 对HREV预测的最佳SSM切断可能受到肝硬化病因的影响.
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