Comparison of three cut-offs to diagnose clinically significant portal hypertension by liver stiffness in chronic viral liver diseases: a meta-analysis
| Autor: | Zida Ma, Jianbo Huang, Ashok Kumar, Matthew T Kitson, Jinzhen Song, Yan Luo, Shiyu Liu, Philipp Schwabl, Romanas Zykus, Qiang Lu |
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| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
Likelihood ratios in diagnostic testing Gastroenterology 03 medical and health sciences Liver disease 0302 clinical medicine Liver stiffness Internal medicine Included study Hypertension Portal medicine Humans Radiology Nuclear Medicine and imaging In patient business.industry General Medicine medicine.disease Elasticity Liver 030220 oncology & carcinogenesis Meta-analysis Portal hypertension Elasticity Imaging Techniques 030211 gastroenterology & hepatology Radiology business Transient elastography |
| Zdroj: | European radiology. 28(12) |
| ISSN: | 1432-1084 |
| Popis: | Transient elastography-based liver stiffness value (TE-LSV) has been investigated for assessing clinically significant portal hypertension (CSPH). The aetiology of CSPH is an important factor determining TE-LSV. There is insufficient evidence for selecting cut-off values.This study performed a meta-analysis to compare the three most widely used cut-off values (around 13.6 kPa, 18 kPa and 22kPa) of TE-LSV for the diagnosis of CSPH in patients with chronic viral liver disease.The PubMed, Ovid, Web of Science and Cochrane Library databases were searched. Diagnostic data for cut-off values around 13.6 kPa, 18 kPa and 22 kPa in each included study were extracted. The bivariate model was performed to estimate pooled sensitivity, specificity, positive likelihood ratio (LR+) and negative likelihood ratio (LR-).Eleven studies assessing 910 patients were included in this meta-analysis. Pooled sensitivities of cut-off values around 13.6 kPa, 18 kPa and 22 kPa were 0.96 (95% CI 0.93-0.97), 0.85 (0.81-0.89) and 0.74 (0.66-0.80), respectively; pooled specificities were 0.60 (0.47-0.75), 0.80 (0.71-0.87) and 0.94 (0.86-0.97), respectively. Pooled LR+ values were 2.4 (1.6-3.7), 4.4 (2.9-6.8) and 11.5 (5.5-23.5) for cut-off values around 13.6 kPa, 18 kPa and 22 kPa, respectively, for pooled LR- values of 0.07 (0.04-0.13), 0.17 (0.12-0.25) and 0.28 (0.22-0.36), respectively.Cut-off values around 13.6 kPa (high sensitivity) and 22 kPa (high specificity) could be used as screening and confirmation tools, respectively, in the diagnosis of CSPH. Overall, the cut-off value around 22 kPa showed the best performance.Transient elastography-based liver stiffness could be used to diagnose portal hypertension. Comparison of certain cut-off values would provide more information for clinical decision-making. Cut-off around 13.6 kPa was able to exclude clinically significant portal hypertension (CSPH) effectively. Cut-off around 22 kPa was able to confirm CSPH effectively. |
| Databáze: | OpenAIRE |
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