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学科主题: 临床医学
题名:
Magnetic Resonance Elastography and Biomarkers to Assess Fibrosis From Recurrent Hepatitis C in Liver Transplant Recipients
作者: 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
发表日期: 2011-09-01
DOI: 10.1097/TP.0b013e31822805fa
卷: 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
所属项目编号: R01 CA126809
项目资助者: NIH
WOS记录号: WOS:000294245400014
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/61601
Appears in Collections:北京大学第二临床医学院_放射科_期刊论文

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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

Recommended Citation:
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.
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