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学科主题临床医学
Magnetic Resonance Elastography and Biomarkers to Assess Fibrosis From Recurrent Hepatitis C in Liver Transplant Recipients
Lee, Victoria S.1; Miller, Frank H.2; Omary, Reed A.2; Wang, Yi3; Ganger, Daniel R.1; Wang, Edward1; Rao, Sambasiva4; Levitsky, Josh1
关键词Noninvasive tests Hepatic fibrosis Liver biopsy Liver transplantation Hepatitis C virus
刊名TRANSPLANTATION
2011-09-01
DOI10.1097/TP.0b013e31822805fa
92期:5页:581-586
收录类别SCI
文章类型Article
WOS标题词Science & Technology
类目[WOS]Immunology ; Surgery ; Transplantation
研究领域[WOS]Immunology ; Surgery ; Transplantation
关键词[WOS]PLATELET RATIO INDEX ; TRANSIENT ELASTOGRAPHY ; VIRAL-HEPATITIS ; MR ELASTOGRAPHY ; BIOPSY ; DIAGNOSIS ; CIRRHOSIS ; PROGRESSION ; MARKERS ; SCORES
英文摘要

Background. Imaging techniques evaluating liver stiffness (magnetic resonance elastography [MRE]) and biomarkers may be useful indicators of fibrosis stage in hepatitis C virus (HCV) + patients. Our aim was to compare the accuracy of MRE and biomarkers in staging fibrosis because of recurrent HCV in liver transplant (LT) recipients with hepatocellular carcinoma.

Methods. Liver magnetic resonance imaging and MRE, FIBROSpectII, aspartate aminotransferase-to-platelet ratio index (aspartate aminotransferase [AST]: platelet index), AST: alanine aminotransferase ratio, and magnetic resonance imaging/MRE-guided biopsies targeting the stiffest regions (right and left lobes) were performed in HCV + LT recipients. Sensitivity, specificity, positive predictive value (PPV)/negative predictive value (NPV), and likelihood ratios were calculated for the best cutoff by receiver operating characteristic analysis.

Results. Thirty-two recipients were included: 28 men, age 60 (+/- 6.4) years, and time since LT 3.25 (+/- 1.68) years. Both MRE(P=0.0001) and FIBROSpectII (P=0.009) were significantly different between no fibrosis and more than or equal to stage 1 groups, whereas aspartate aminotransferase-to-platelet ratio index and AST: alanine aminotransferase ratio were not different. Areas under the receiver operating characteristic curve were 0.87 for MRE and 0.84 for FIBROSpectII. MRE cutoff of 3.81 kPa had 87.5% sensitivity, 79.2% specificity, 58.3% PPV, and 95.0% NPV; FIBROSpectII cutoff of 42 had 87.5% sensitivity, 70.0% specificity, 53.8% PPV, and 93.3% NPV for detection of more than or equal to stage 1 fibrosis. Two patients had high MRE values because of unexpected acute rejection and portal vein thrombosis.

Conclusions. MRE and FIBROSpectII are highly sensitive in detecting fibrosis due to recurrent HCV. Both are limited by the low specificity/PPV and confounding because of other graft complications. Values below the MRE and FIBROSpectII cutoffs, however, strongly suggest the absence of fibrosis and may avert the need for protocol biopsy staging.

语种英语
WOS记录号WOS:000294245400014
项目编号R01 CA126809
资助机构NIH
引用统计
被引频次:30[WOS]   [WOS记录]     [WOS相关记录]
文献类型期刊论文
条目标识符http://ir.bjmu.edu.cn/handle/400002259/61601
专题北京大学第二临床医学院_放射科
作者单位1.Northwestern Univ, Div Hepatol, Feinberg Sch Med, Chicago, IL 60611 USA
2.Northwestern Univ, Dept Radiol, Feinberg Sch Med, Chicago, IL 60611 USA
3.Peking Univ, Dept Radiol, Peoples Hosp, Beijing 100871, Peoples R China
4.Northwestern Univ, Dept Pathol, Feinberg Sch Med, Chicago, IL 60611 USA
推荐引用方式
GB/T 7714
Lee, Victoria S.,Miller, Frank H.,Omary, Reed A.,et al. Magnetic Resonance Elastography and Biomarkers to Assess Fibrosis From Recurrent Hepatitis C in Liver Transplant Recipients[J]. TRANSPLANTATION,2011,92(5):581-586.
APA Lee, Victoria S..,Miller, Frank H..,Omary, Reed A..,Wang, Yi.,Ganger, Daniel R..,...&Levitsky, Josh.(2011).Magnetic Resonance Elastography and Biomarkers to Assess Fibrosis From Recurrent Hepatitis C in Liver Transplant Recipients.TRANSPLANTATION,92(5),581-586.
MLA Lee, Victoria S.,et al."Magnetic Resonance Elastography and Biomarkers to Assess Fibrosis From Recurrent Hepatitis C in Liver Transplant Recipients".TRANSPLANTATION 92.5(2011):581-586.
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