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Performance of 2‐Dimensional Ultrasound Shear Wave Elastography in Liver Fibrosis Detection Using Magnetic Resonance Elastography as the Reference Standard
Author(s) -
Song Pengfei,
Mellema Daniel C.,
Sheedy Shan P.,
Meixner Duane D.,
Karshen Ryan M.,
Urban Matthew W.,
Manduca Armando,
Sanchez William,
Callstrom Matthew R.,
Greenleaf James F.,
Chen Shigao
Publication year - 2016
Publication title -
journal of ultrasound in medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.574
H-Index - 91
eISSN - 1550-9613
pISSN - 0278-4297
DOI - 10.7863/ultra.15.03036
Subject(s) - medicine , magnetic resonance elastography , intercostal space , receiver operating characteristic , elastography , ultrasound , intercostal muscle , magnetic resonance imaging , intercostal nerves , radiology , nuclear medicine , liver fibrosis , fibrosis , pathology , surgery , respiratory system
Objectives To investigate the correlation between 2‐dimensional (2D) ultrasound shear wave elastography (SWE) and magnetic resonance elastography (MRE) in liver stiffness measurement and the diagnostic performance of 2D SWE for liver fibrosis when imaging from different intercostal spaces and using MRE as the reference standard. Methods Two‐dimensional SWE was performed on 47 patients. One patient was excluded from the study. Each of the remaining 46 patients underwent same‐day MRE for clinical purposes. The study was compliant with the Health Insurance Portability and Accountability Act and approved by the Institutional Review Board. Informed consent was obtained from each patient. Two‐dimensional SWE measurements were acquired from the ninth, eighth, and seventh intercostal spaces. The correlation with MRE was calculated at each intercostal space and multiple intercostal spaces combined. The performance of 2D SWE in diagnosing liver fibrosis was evaluated by receiver operating characteristic curve analysis using MRE as the standard. Results The 47 patients who initially underwent 2D SWE included 22 female and 25 male patients (age range, 19–77 years). The highest correlation between 2D SWE and MRE was from the eighth and seventh intercostal spaces ( r = 0.68–0.76). The ranges of the areas under the receiver operating characteristic curves for separating normal or inflamed livers from fibrotic livers using MRE as the clinical reference were 0.84 to 0.92 when using the eighth and seventh intercostal spaces individually and 0.89 to 0.90 when combined. Conclusions The results suggest that 2D SWE and MRE are well correlated when SWE is performed at the eighth and seventh intercostal spaces. The ninth intercostal space is less reliable for diagnosing fibrosis with 2D SWE. Combining measurements from multiple intercostal spaces does not significantly improve the performance of 2D SWE for detection of fibrosis.