The Application Of Transient Elastography And Two-dimensional Shear Wave Elastography In The Evaluation Of Liver Fibrosis And Esophageal And Gastric Varices

Objective: To analyze and compare the application of transient elastography and two-dimensional shear wave elastography in the evaluation of liver fibrosis and esophageal and gastric varices.Methods:1.80 patients were selected from the Department of Hepatology of traditional Chinese and Western Medicine in our hospital,among which 73 with chronic liver disease received liver biopsy.Before the biopsy,they received transient elastography(TE)and two-dimensional shear wave elastography(2D-SWE)respectively.And other patients without chronic viral liver disease,alcoholic liver disease,drug-induced liver disease and other liver diseases are the control group(F0)and no liver biopsy was performed to them.Taking the pathological results of liver biopsy as the gold standard,the sensitivity and specificity of TE and 2D-SWE in the diagnosis of liver fibrosis were analyzed.2.53 patients with cirrhosis were selected from the Department of liver diseases of traditional Chinese and Western medicine,and all of them were examined by gastroscopy.The sensitivity and specificity of TE and 2D-SWE in the diagnosis of esophageal and gastric varices were analyzed.Results:1.Assessment of liver fibrosis: Transient elastography(TE): The area under ROC curve of liver fibrosis ≥F2,≥F4 were 0.904 and 0.891 respectively.The sensitivity were 72.3% and 90.9% respectively.The specificity were 100% and 75.6% respectively.The critical values were 8.45 kpa and 10.05 kpa respectively.Two-Dimensional shear wave elastography(2D-SWE): The area under ROC curve of liver fibrosis ≥F2,≥F4 were 0.946 and 0.942 respectively.The sensitivity were 86.2% and 93.9% respectively.The specificity were 92.3% and 84.4% respectively.The critical values were 7.75 kpa and 10.10 kpa respectively.2.Evaluation of esophageal and gastric varices: Transient elastography(TE): when the hardness of liver is more than or equal to 13.3KPa,there may be esophageal and gastric varices in patients with cirrhosis.The area under the ROC curve is 0.842,the sensitivity is 82.1%,and the specificity is 80%.Two dimensional shear wave elastography(SWE): when the liver hardness is ≥ 11.85 kpa,esophageal and gastric varices may exist in patients with cirrhosis.The area under ROC curve is 0.776,the sensitivity is 96.4%,and the specificity is 56.0%.Conclusion:Based on the gold standard of liver biopsy pathological results,TE and 2D-SWE have high sensitivity and specificity in the diagnosis of liver fibrosis.In addition,2D-SWE has higher sensitivity and specificity than TE.This is of great significance in evaluating the degree of liver fibrosis as well as determining the plan of treatment and treatment time of patients.With gastroscopy as the gold standard,TE has higher sensitivity and specificity than 2D-SWE,which is of great significance in evaluating the degree of esophageal and gastric varices.