Elastografía en tiempo real (Supersonic), experiencia de un centro en Bogotá
DOI:
https://doi.org/10.22516/25007440.594Palabras clave:
2D-SWE, elastografía en tiempo real, Supersonic, fibrosis hepática, evaluación no invasiva de la fibrosis hepáticaResumen
Introducción: la elastografía en tiempo real, 2D-SWE (Supersonic), es una prueba no invasiva que se utiliza para determinar la elasticidad del hígado y, de esa forma, calcular el grado de fibrosis hepática. En Colombia, la prueba se introdujo en 2016 y no existen hasta el momento estudios del comportamiento de la prueba en todos los pacientes hepáticos, solo se han publicado en pacientes sanos y cirróticos.
Objetivo: analizar la experiencia de la aplicación de la elastografía en tiempo real, en sujetos atendidos en el centro de enfermedades hepáticas y digestivas de Bogotá, Colombia.
Materiales y métodos: estudio descriptivo retrospectivo de una cohorte de sujetos atendidos entre marzo de 2016 y julio de 2017. Se realizó una historia clínica completa y una prueba de elastografía en tiempo real (Supersonic).
Resultados: se incluyeron 654 sujetos, con una mediana de edad de 55 años (rango intercuartílico [RIC]: 45-64). La mediana de valores de fibrosis expresada en kilopascales (kPs) fue de 8,3, con un promedio de 5 mediciones. Se observó una diferencia significativa en el grado de fibrosis entre los grupos de edad y en relación con el diagnóstico final, donde se evidenció una mayor fibrosis en el grupo de enfermedades colestásicas (autoinmune, colangitis biliar primaria [CBP] y superposición autoinmune-CBP). La tasa global de fracaso fue menor al 1 %.
Conclusiones: es la primera descripción del comportamiento de la prueba a nivel nacional. Los valores de rigidez hepática observados en los diferentes estadios demuestran la utilidad de la prueba para la determinación de la fibrosis hepática en pacientes con diferentes patologías.
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Referencias bibliográficas
European Association for the Study of the Liver. EASL Clinical Practice Guidelines: management of hepatitis C virus infection. J Hepatol. 2011;55(2):245-64. https://doi.org/10.1016/j.jhep.2011.02.023
Ghany MG, Strader DB, Thomas DL, Seeff LB; American Association for the Study of Liver Diseases. Diagnosis, management, and treatment of hepatitis C: an update. Hepatology. 2009;49(4):1335-74. https://doi.org/10.1002/hep.22759
Bedossa P, Poynard T. An algorithm for the grading of activity in chronic hepatitis C. The METAVIR Cooperative Study Group. Hepatology. 1996;24(2):289-93. https://doi.org/10.1002/hep.510240201
Intraobserver and interobserver variations in liver biopsy interpretation in patients with chronic hepatitis C. The French METAVIR Cooperative Study Group. Hepatology. 1994;20(1 Pt 1):15-20.
Soloway RD, Baggenstoss AH, Schoenfield LJ, Summerskill WH. Observer error and sampling variability tested in evaluation of hepatitis and cirrhosis by liver biopsy. Am J Dig Dis. 1971;16(12):1082-6.
Bedossa P, Dargère D, Paradis V. Sampling variability of liver fibrosis in chronic hepatitis C. Hepatology. 2003;38(6):1449-57. https://doi.org/10.1016/j.hep.2003.09.022
Deffieux T, Montaldo G, Tanter M, Fink M. Shear wave spectroscopy for in vivo quantification of human soft tissues visco-elasticity. IEEE Trans Med Imaging. 2009;28(3):313-22. https://doi.org/10.1109/TMI.2008.925077
Sandrin L, Fourquet B, Hasquenoph JM, Yon S, Fournier C, Mal F, Christidis C, Ziol M, Poulet B, Kazemi F, Beaugrand M, Palau R. Transient elastography: a new noninvasive method for assessment of hepatic fibrosis. Ultrasound Med Biol. 2003;29(12):1705-13. https://doi.org/10.1016/j.ultrasmedbio.2003.07.001
Castéra L, Vergniol J, Foucher J, Le Bail B, Chanteloup E, Haaser M, Darriet M, Couzigou P, De Lédinghen V. Prospective comparison of transient elastography, Fibrotest, APRI, and liver biopsy for the assessment of fibrosis in chronic hepatitis C. Gastroenterology. 2005;128(2):343-50. https://doi.org/10.1053/j.gastro.2004.11.018
Friedrich-Rust M, Ong MF, Martens S, Sarrazin C, Bojunga J, Zeuzem S, Herrmann E. Performance of transient elastography for the staging of liver fibrosis: a meta-analysis. Gastroenterology. 2008;134(4):960-74. https://doi.org/10.1053/j.gastro.2008.01.034
Martínez SM, Crespo G, Navasa M, Forns X. Noninvasive assessment of liver fibrosis. Hepatology. 2011;53(1):325-35. https://doi.org/10.1002/hep.24013
Cassinotto C, Lapuyade B, Mouries A, Hiriart JB, Vergniol J, Gaye D, Castain C, Le Bail B, Chermak F, Foucher J, Laurent F, Montaudon M, De Ledinghen V. Non-invasive assessment of liver fibrosis with impulse elastography: comparison of Supersonic Shear Imaging with ARFI and FibroScan®. J Hepatol. 2014;61(3):550-7. https://doi.org/10.1016/j.jhep.2014.04.044
Bavu E, Gennisson JL, Couade M, Bercoff J, Mallet V, Fink M, Badel A, Vallet-Pichard A, Nalpas B, Tanter M, Pol S. Noninvasive in vivo liver fibrosis evaluation using supersonic shear imaging: a clinical study on 113 hepatitis C virus patients. Ultrasound Med Biol. 2011;37(9):1361-73. https://doi.org/10.1016/j.ultrasmedbio.2011.05.016
Ferraioli G, Tinelli C, Dal Bello B, Zicchetti M, Filice G, Filice C; Liver Fibrosis Study Group. Accuracy of real-time shear wave elastography for assessing liver fibrosis in chronic hepatitis C: a pilot study. Hepatology. 2012;56(6):2125-33. https://doi.org/10.1002/hep.25936
Ferraioli G, Tinelli C, Zicchetti M, Above E, Poma G, Di Gregorio M, Filice C. Reproducibility of real-time shear wave elastography in the evaluation of liver elasticity. Eur J Radiol. 2012;81(11):3102-6. https://doi.org/10.1016/j.ejrad.2012.05.030
Sirli R, Bota S, Sporea I, Jurchis A, Popescu A, Gradinaru-Tascău O, Szilaski M. Liver stiffness measurements by means of supersonic shear imaging in patients without known liver pathology. Ultrasound Med Biol. 2013;39(8):1362-7. https://doi.org/10.1016/j.ultrasmedbio.2013.03.021
Cha SW, Jeong WK, Kim Y, Kim MY, Kim J, Kim SY, Ryu JA, Kim TY, Sohn JH, Kim YH. Nondiseased liver stiffness measured by shear wave elastography: a pilot study. J Ultrasound Med. 2014;33(1):53-60. https://doi.org/10.7863/ultra.33.1.53
Leung VY, Shen J, Wong VW, Abrigo J, Wong GL, Chim AM, Chu SH, Chan AW, Choi PC, Ahuja AT, Chan HL, Chu WC. Quantitative elastography of liver fibrosis and spleen stiffness in chronic hepatitis B carriers: comparison of shear-wave elastography and transient elastography with liver biopsy correlation. Radiology. 2013;269(3):910-8. https://doi.org/10.1148/radiol.13130128
Prieto O JE, Sánchez P S, Prieto O RG, Garzón-Orjuela N, Eslava-Schmalbach J. Elastografía en tiempo real (supersonic): comportamiento de la prueba en sujetos sanos de Bogotá. Rev Colomb Gastroenterol. 2017;32(4):332-336. https://doi.org/10.22516/25007440.176
Prieto O JE, Garzón-Orjuela N, Sánchez P S, Prieto O RG, Ochoa D AF, Eslava-Schmalbach J. Elastografía en tiempo real (Supersonic): comportamiento de la prueba en una cohorte de pacientes con cirrosis en un centro médico de Bogotá. Rev Colomb Gastroenterol. 2018;33(3):235-241. http://dx.doi.org/10.22516/25007440.201
European Association for Study of Liver; Asociacion Latinoamericana para el Estudio del Higado. EASL-ALEH Clinical Practice Guidelines: Non-invasive tests for evaluation of liver disease severity and prognosis. J Hepatol. 2015;63(1):237-64. https://doi.org/10.1016/j.jhep.2015.04.006
Friedrich-Rust M, Poynard T, Castera L. Critical comparison of elastography methods to assess chronic liver disease. Nat Rev Gastroenterol Hepatol. 2016;13(7):402-11. https://doi.org/10.1038/nrgastro.2016.86
Dietrich CF, Bamber J, Berzigotti A, Bota S, Cantisani V, Castera L, Cosgrove D, Ferraioli G, Friedrich-Rust M, Gilja OH, Goertz RS, Karlas T, de Knegt R, de Ledinghen V, Piscaglia F, Procopet B, Saftoiu A, Sidhu PS, Sporea I, Thiele M. EFSUMB Guidelines and Recommendations on the Clinical Use of Liver Ultrasound Elastography, Update 2017 (Long Version). Ultraschall Med. 2017;38(4):e16-e47. https://doi.org/10.1055/s-0043-103952
Feng JC, Li J, Wu XW, Peng XY. Diagnostic Accuracy of SuperSonic Shear Imaging for Staging of Liver Fibrosis: A Meta-analysis. J Ultrasound Med. 2016;35(2):329-39. https://doi.org/10.7863/ultra.15.03032
Li C, Zhang C, Li J, Huo H, Song D. Diagnostic Accuracy of Real-Time Shear Wave Elastography for Staging of Liver Fibrosis: A Meta-Analysis. Med Sci Monit. 2016;22:1349-59. https://doi.org/10.12659/msm.895662
Procopet B, Berzigotti A, Abraldes JG, Turon F, Hernandez-Gea V, García-Pagán JC, Bosch J. Real-time shear-wave elastography: applicability, reliability and accuracy for clinically significant portal hypertension. J Hepatol. 2015;62(5):1068-75. https://doi.org/10.1016/j.jhep.2014.12.007
Guibal A, Renosi G, Rode A, Scoazec JY, Guillaud O, Chardon L, Munteanu M, Dumortier J, Collin F, Lefort T. Shear wave elastography: An accurate technique to stage liver fibrosis in chronic liver diseases. Diagn Interv Imaging. 2016;97(1):91-9. https://doi.org/10.1016/j.diii.2015.11.001
Zeng J, Liu GJ, Huang ZP, Zheng J, Wu T, Zheng RQ, Lu MD. Diagnostic accuracy of two-dimensional shear wave elastography for the non-invasive staging of hepatic fibrosis in chronic hepatitis B: a cohort study with internal validation. Eur Radiol. 2014;24(10):2572-81. https://doi.org/10.1007/s00330-014-3292-9
Jiang T, Tian G, Zhao Q, Kong D, Cheng C, Zhong L, Li L. Diagnostic Accuracy of 2D-Shear Wave Elastography for Liver Fibrosis Severity: A Meta-Analysis. PLoS One. 2016;11(6):e0157219. https://doi.org/10.1371/journal.pone.0157219
Herrmann E, de Lédinghen V, Cassinotto C, Chu WC, Leung VY, Ferraioli G, Filice C, Castera L, Vilgrain V, Ronot M, Dumortier J, Guibal A, Pol S, Trebicka J, Jansen C, Strassburg C, Zheng R, Zheng J, Francque S, Vanwolleghem T, Vonghia L, Manesis EK, Zoumpoulis P, Sporea I, Thiele M, Krag A, Cohen-Bacrie C, Criton A, Gay J, Deffieux T, Friedrich-Rust M. Assessment of biopsy-proven liver fibrosis by two-dimensional shear wave elastography: An individual patient data-based meta-analysis. Hepatology. 2018;67(1):260-272. https://doi.org/10.1002/hep.29179
Deng H, Qi X, Zhang T, Qi X, Yoshida EM, Guo X. Supersonic shear imaging for the diagnosis of liver fibrosis and portal hypertension in liver diseases: a meta-analysis. Expert Rev Gastroenterol Hepatol. 2018;12(1):91-98. https://doi.org/10.1080/17474124.2018.1412257
Cassinotto C, Boursier J, de Lédinghen V, Lebigot J, Lapuyade B, Cales P, Hiriart JB, Michalak S, Bail BL, Cartier V, Mouries A, Oberti F, Fouchard-Hubert I, Vergniol J, Aubé C. Liver stiffness in nonalcoholic fatty liver disease: A comparison of supersonic shear imaging, FibroScan, and ARFI with liver biopsy. Hepatology. 2016;63(6):1817-27. https://doi.org/10.1002/hep.28394
Yoneda M, Thomas E, Sclair SN, Grant TT, Schiff ER. Supersonic Shear Imaging and Transient Elastography With the XL Probe Accurately Detect Fibrosis in Overweight or Obese Patients With Chronic Liver Disease. Clin Gastroenterol Hepatol. 2015;13(8):1502-9.e5. https://doi.org/10.1016/j.cgh.2015.03.014
Poynard T, Munteanu M, Luckina E, Perazzo H, Ngo Y, Royer L, Fedchuk L, Sattonnet F, Pais R, Lebray P, Rudler M, Thabut D, Ratziu V. Liver fibrosis evaluation using real-time shear wave elastography: applicability and diagnostic performance using methods without a gold standard. J Hepatol. 2013;58(5):928-35. https://doi.org/10.1016/j.jhep.2012.12.021
Poynard T, Lebray P, Ingiliz P, Varaut A, Varsat B, Ngo Y, Norha P, Munteanu M, Drane F, Messous D, Bismut FI, Carrau JP, Massard J, Ratziu V, Giordanella JP. Prevalence of liver fibrosis and risk factors in a general population using non-invasive biomarkers (FibroTest). BMC Gastroenterol. 2010;10:40. https://doi.org/10.1186/1471-230X-10-40
Mahrouf-Yorgov M, Collin de l’Hortet A, Cosson C, Slama A, Abdoun E, Guidotti JE, Fromenty B, Mitchell C, Gilgenkrantz H. Increased susceptibility to liver fibrosis with age is correlated with an altered inflammatory response. Rejuvenation Res. 2011;14(4):353-63. https://doi.org/10.1089/rej.2010.1146
Scaglione S, Kliethermes S, Cao G, Shoham D, Durazo R, Luke A, Volk ML. The Epidemiology of Cirrhosis in the United States: A Population-based Study. J Clin Gastroenterol. 2015;49(8):690-6. https://doi.org/10.1097/MCG.0000000000000208
Guarner V, Rubio-Ruiz ME. Low-grade systemic inflammation connects aging, metabolic syndrome and cardiovascular disease. Interdiscip Top Gerontol. 2015;40:99-106. https://doi.org/10.1159/000364934
Castéra L, Foucher J, Bernard PH, Carvalho F, Allaix D, Merrouche W, Couzigou P, de Lédinghen V. Pitfalls of liver stiffness measurement: a 5-year prospective study of 13,369 examinations. Hepatology. 2010;51(3):828-35. https://doi.org/10.1002/hep.23425
Wang H, Zheng P, Sang L, Wang X. Does Operator Experience and the Q-Box Diameter Affect the Repeatability of Liver Stiffness Measurements Obtained by 2-Dimensional Shear Wave Elastography? J Ultrasound Med. 2020;39(4):741-747. https://doi.org/10.1002/jum.15153
Grădinaru-Taşcău O, Sporea I, Bota S, Jurchiş A, Popescu A, Popescu M, Şirli R, Szilaski M. Does experience play a role in the ability to perform liver stiffness measurements by means of supersonic shear imaging (SSI)? Med Ultrason. 2013;15(3):180-3. https://doi.org/10.11152/mu.2013.2066.153.ogt1is2
Sporea I, Bota S, Gradinaru-Taşcău O, Sirli R, Popescu A, Jurchiş A. Which are the cut-off values of 2D-Shear Wave Elastography (2D-SWE) liver stiffness measurements predicting different stages of liver fibrosis, considering Transient Elastography (TE) as the reference method? Eur J Radiol. 2014 Mar;83(3):e118-22. https://doi.org/10.1016/j.ejrad.2013.12.011
Thiele M, Hugger MB, Kim Y, Rautou PE, Elkrief L, Jansen C, Verlinden W, Allegretti G, Israelsen M, Stefanescu H, Piscaglia F, García-Pagán JC, Franque S, Berzigotti A, Castera L, Jeong WK, Trebicka J, Krag A. 2D shear wave liver elastography by Aixplorer to detect portal hypertension in cirrhosis: An individual patient data meta-analysis. Liver Int. 2020;40(6):1435-1446. https://doi.org/10.1111/liv.14439
Cassinotto C, Lapuyade B, Guiu B, Marraud des Grottes H, Piron L, Merrouche W, Irles-Depe M, Molinari N, De Ledinghen V. Agreement Between 2-Dimensional Shear Wave and Transient Elastography Values for Diagnosis of Advanced Chronic Liver Disease. Clin Gastroenterol Hepatol. 2020;18(13):2971-2979.e3. https://doi.org/10.1016/j.cgh.2020.04.034
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