2D shear wave elastography combined with MELD improved prognostic accuracy in patients with acute-on-chronic hepatitis B liver failure.
Eur Radiol
; 28(10): 4465-4474, 2018 Oct.
Article
en En
| MEDLINE
| ID: mdl-29696433
ABSTRACT
OBJECTIVES:
To evaluate accuracy of two-dimensional shear wave elastography (2D SWE) and develop and validate a new prognostic score in predicting prognosis of acute-on-chronic liver failure (ACLF) patients.METHODS:
From 1 October 2013 to 30 September 2015, we consecutively enrolled 290 patients, sequentially collected data (including 2D SWE, ultrasound parameters, laboratory data and prognostic scores) and recorded patients' outcome (recovering/steady or worsening) during a 90-day follow-up period. We evaluated ability of 2D SWE to predict outcomes of acute-on-chronic hepatitis B liver failure (ACLF-HBV) patients. We developed a new score (MELD-SWE, combining MELD and SWE values) for predicting mortality risk of ACLF-HBV in 179 patients in a derivation group, and validated in 111 patients.RESULTS:
2D SWE values were higher in worsening patients than recovering/steady ones (p < 0.001). Accuracy of 2D SWE in predicting outcomes of ACLF-HBV was comparable to that of the MELD score (p = 0.441). MELD-SWE showed a significantly higher prognostic value than MELD in both derivation (AUROC, 0.80 vs. 0.76, p = 0.040) and validation (AUROC, 0.87 vs. 0.82, p = 0.018) group.CONCLUSIONS:
The MELD-SWE score, combining MELD and SWE values, was superior to MELD alone for outcoming prediction in patients with ACLF-HBV. KEY POINTS ⢠2D SWE is a simple prognostic evaluation tool in patients with ACLF-HBV. ⢠MELD-SWE was created in this study 1.3×MELD + 0.3×2D SWE (kPa). ⢠MELD-SWE score was superior to MELD alone for outcoming prediction in ACLF-HBV. ⢠In this study, 46.8 was the optimal cut-off value of MELD-SWE score.Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Hepatitis B Crónica
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Diagnóstico por Imagen de Elasticidad
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Enfermedad Hepática en Estado Terminal
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Insuficiencia Hepática Crónica Agudizada
Tipo de estudio:
Diagnostic_studies
/
Prognostic_studies
Límite:
Adult
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Aged
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Female
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Humans
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Male
/
Middle aged
Idioma:
En
Revista:
Eur Radiol
Asunto de la revista:
RADIOLOGIA
Año:
2018
Tipo del documento:
Article
País de afiliación:
China