학술논문
Measurement of Liver Stiffness with 2D-Shear Wave Elastography (2D-SWE) in Bariatric Surgery Candidates Reveals Acceptable Diagnostic Yield Compared to Liver Biopsy.
Document Type
Academic Journal
Author
Jamialahmadi T; Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, 9177948564, Iran.; Nematy M; Biochemistry and Nutrition Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, 9177948564, Iran.; Jangjoo A; Surgical Oncology Research Center, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, 9177948564, Iran.; Goshayeshi L; Department of Gastroenterology and Hepatology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.; Gastroenterology and Hepatology Research Center, Mashhad University of Medical Sciences, Mashhad, 9177948564, Iran.; Rezvani R; Biochemistry and Nutrition Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, 9177948564, Iran.; Ghaffarzadegan K; Pathology Department, Education and Research Department, Razavi Hospital, Mashhad, 9177948564, Iran.; Nooghabi MJ; Department of Statistics, Faculty of Mathematical Sciences, Ferdowsi University of Mashhad, Mashhad, 9177948944, Iran.; Shalchian P; Hazrat Zahra Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.; Zangui M; Gastroenterology and Hepatology Research Center, Mashhad University of Medical Sciences, Mashhad, 9177948564, Iran.; Javid Z; Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, 9177948564, Iran.; Doaei S; Research Center of Health and Environment, Guilan University of Medical Sciences, Rasht, 1313973476, Iran.; Rajabzadeh F; Department of Radiology, Faculty of Medicine, Islamic Azad University-Mashhad Branch, Mashhad, 9137714639, Iran. Farnood@yahoo.com.
Source
Publisher: Springer Science + Business Media Country of Publication: United States NLM ID: 9106714 Publication Model: Print Cited Medium: Internet ISSN: 1708-0428 (Electronic) Linking ISSN: 09608923 NLM ISO Abbreviation: Obes Surg Subsets: MEDLINE
Subject
Language
English
Abstract
Background: Nonalcoholic fatty liver disease (NAFLD) is common among severely obese patients. Two-dimensional shear wave elastography (2D-SWE) has been validated as a noninvasive diagnostic tool for liver stiffness measurement. However, the technical feasibility and accuracy of this method in severely obese patients are still under debate.
Objective: We aimed to assess the diagnostic accuracy of 2D-SWE in bariatric surgery candidates in comparison with the gold standard liver biopsy.
Methods: Ninety severely obese candidates for bariatric surgery were included. Liver stiffness was measured using 2D-SWE 14 days before liver biopsy. Liver biopsy was taken on the day of surgery. The area under the receiver operating curve (AUROC) was calculated for the staging of liver fibrosis.
Results: 2D-SWE was performed in 97.3% of patients successfully. Histologic stages of fibrosis (F0-F4) were detected in 34.2%, 36%, 6.3%, 3.6%, and 0.9% of patients, respectively. The AUROC for 2D-SWE was 0.77 for F1, 0.72 for F2, 0.77 for F3, and 0.70 for F4. In univariate analysis, 2D-SWE values were correlated with BMI, waist circumference, NAFLD activity score (NAS), and steatosis, whereas these components did not affect liver stiffness in multivariate analysis.
Conclusion: Two-dimensional shear wave elastography of the liver can be feasible and has good accuracy in severely obese candidates for bariatric surgery. Therefore, 2D-SWE may be a good option for assessing liver fibrosis, especially in the early stages of fibrosis to lessen complications of surgery in this population. However, this method should be applied on a larger scale for late stage of fibrosis.
Objective: We aimed to assess the diagnostic accuracy of 2D-SWE in bariatric surgery candidates in comparison with the gold standard liver biopsy.
Methods: Ninety severely obese candidates for bariatric surgery were included. Liver stiffness was measured using 2D-SWE 14 days before liver biopsy. Liver biopsy was taken on the day of surgery. The area under the receiver operating curve (AUROC) was calculated for the staging of liver fibrosis.
Results: 2D-SWE was performed in 97.3% of patients successfully. Histologic stages of fibrosis (F0-F4) were detected in 34.2%, 36%, 6.3%, 3.6%, and 0.9% of patients, respectively. The AUROC for 2D-SWE was 0.77 for F1, 0.72 for F2, 0.77 for F3, and 0.70 for F4. In univariate analysis, 2D-SWE values were correlated with BMI, waist circumference, NAFLD activity score (NAS), and steatosis, whereas these components did not affect liver stiffness in multivariate analysis.
Conclusion: Two-dimensional shear wave elastography of the liver can be feasible and has good accuracy in severely obese candidates for bariatric surgery. Therefore, 2D-SWE may be a good option for assessing liver fibrosis, especially in the early stages of fibrosis to lessen complications of surgery in this population. However, this method should be applied on a larger scale for late stage of fibrosis.