2D shear wave elastography combined with MELD improved prognostic accuracy in patients with acute-on-chronic hepatitis B liver failure
- 25.04.2018
- Ultrasound
Erschienen in:
- Verfasst von
- Jie-Yang Jin
- Yu-Bao Zheng
- Jian Zheng
- Jing Liu
- Yong-Jiang Mao
- Shi-Gao Chen
- Zhi-Liang Gao
- Rong-Qin Zheng
- Erschienen in
- European Radiology | Ausgabe 10/2018
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.
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- Titel
- 2D shear wave elastography combined with MELD improved prognostic accuracy in patients with acute-on-chronic hepatitis B liver failure
- Verfasst von
-
Jie-Yang Jin
Yu-Bao Zheng
Jian Zheng
Jing Liu
Yong-Jiang Mao
Shi-Gao Chen
Zhi-Liang Gao
Rong-Qin Zheng
- Publikationsdatum
- 25.04.2018
- Verlag
- Springer Berlin Heidelberg
- Erschienen in
-
European Radiology / Ausgabe 10/2018
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084 - DOI
- https://doi.org/10.1007/s00330-018-5336-z
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