| Objective: To compare the diagnostic value between two-dimensional shear wave elastography(2D-SWE)and transient elastography(TE)for the stages of liver fibrosis in patients with chronic hepatitis B(CHB).Methods : One hundred and seventy-two cases of CHB patients performed 2D-SWE and TE examinations.The pathological fibrosis stages by ultrasound guided liver biopsy were used as the reference standard to evaluate the diagnostic efficacy of two kinds of elastography.Statistical analysis was performed using SPSS software,version 22.0 and Med Calc 92.1.0.Spearman's rank correlation coefficients were used to analyze the correlation between SWE and TE with histologic fibrosis stage.To assess intraobserver and interobserver error,intraclass correlation coefficients(ICCs)were used.ICCs and 95% confidence intervals(CI)were calculated.One-way analysis of variance was used to evaluate the level of significance of the difference among fibrosis stages in 2D-SWE and TE.Areas under receiver operating characteristics(AUROC)curves were built to discriminate various stages of liver fibrosis between 2D-SWE and TE.The optimal cut-off values were obtained by using Youden index from AUROC curves analysis.A P value<0.05 was considered as statistical significance.Results:1.There are positive interrelationships between two kinds of elastography examinations and liver fibrosis(r=0.844,0.752).There were significant differences between the values of 2D-SWE and TE indifferent pathological fibrosis stages(P < 0.05),and the values increased with the stage of liver fibrosis.2.The receiver operating characteristic curve(ROC curve)was used to compare the diagnostic efficacy between 2D-SWE and TE.The areas under the ROC curves(AUROC)for 2D-SWE of significant liver fibrosis(? S2)were 0.920?0.958 and 0.967,respectively.The AUROC for TE of significant liver fibrosis were 0.849 ? 0.920 and 0.940,respectively.3.2D-SWE showed significantly higher accuracy than TE in significant(S2)and severe(S3)liver fibrosis,but showed similar accuracy with TE in cirrhosis(S4)(S2: Z=3.252,S3:Z = 2.701,P <0.05;S4:Z = 1.484,P >0.05).4.The optimal cut-off for 2D-SWE to diagnose from significant liver fibrosis to cirrhosis were 7.7 k Pa,9.4 k Pa and 11.9 k Pa,respectively and the optimal cut-off for TE to diagnose from significant liver fibrosis to cirrhosis were 8.5 k Pa,9.9 k Pa and 12.4 k Pa,respectively.Conclusion: 2D-SWE and TE have similar diagnostic values in noninvasive diagnosis of liver fibrosis with CHB,but the 2D-SWE which has more clinical application value is superior to TE in S2~S3liver fibrosis. |
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