Reliability of acoustic radiation force impulse shear wave elastography in the evaluation of liver stiffness in morbidly obese patients.

Autor: Chauhan A; Division of Abdominal Imaging, Department of Radiology, University of Minnesota, Minneapolis, Minnesota, USA., Shamchi SP; Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA., Dumon KR; Department of Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA., Williams NN; Department of Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA., Sehgal CM; Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Jazyk: angličtina
Zdroj: Journal of clinical ultrasound : JCU [J Clin Ultrasound] 2020 Sep; Vol. 48 (7), pp. 369-376. Date of Electronic Publication: 2020 Jun 03.
DOI: 10.1002/jcu.22837
Abstrakt: Purpose: To evaluate technical and patient-related factors that can affect the reliability of acoustic radiation force impulse shear wave elastography (ARFI-SWE) in morbidly obese patients.
Methods: A prospective single-center study was performed on 41 patients (32 females, 78%) presenting for preoperative evaluation for bariatric surgery. ARFI-SWE was performed using a 6 to 1.5 MHz curved (6C1) transducer. Hepatic steatosis was mild, moderate, severe, and absent in 24.4%, 12.2%, 43.9%, and 19.5% of patients, respectively. Interquartile range/median (IQR/M) ranged from 0.05 to 2.07 (0.78 ± 0.56 m/s). Twenty patients (48.7%) had reliable measurements (IQR/M < 0.3). Shear wave velocity (SWV) values were >1.34 m/s (clinically significant fibrosis) in 25 of 41 patients (61%) and >2.2 m/s (advanced fibrosis) in 19 patients (46%).
Results: Median SWV was correlated with body mass index (BMI; correlation coefficient [CC] = .37; 95% CI, 0.07-0.61; P-value = .03) and skin-to-liver capsule distance (SLD) (CC = .38; 95% CI, 0.09-0.62; P-value = .01). IQR/M was higher in patients with BMI > 40 (0.24 ± 0.11 vs 0.39 ± 0.25, P-value = .031) and SLD > 3 cm (0.46 ± 0.27 vs 0.23 ± 0.08, P-value = .001), and there was higher number of unreliable examinations among patient with SLD > 3 cm (16/23 vs 5/18, P-value = .01).
Conclusion: ARFI-SWE is technically more challenging among patients with higher BMI and SLD, resulting in a higher number of unreliable studies, which highlights the need for further advancement of ARFI technology.
(© 2020 Wiley Periodicals, Inc.)
Databáze: MEDLINE
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