期刊
ALIMENTARY PHARMACOLOGY & THERAPEUTICS
卷 41, 期 12, 页码 1271-1280出版社
WILEY
DOI: 10.1111/apt.13196
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资金
- GE Healthcare
- American Gastroenterological Association (AGA) Foundation-Sucampo-ASP Designated Research Award in Geriatric Gastroenterology
- T. Franklin Williams Scholarship Award
- Atlantic Philanthropies, Inc
- John A. Hartford Foundation
- American Gastroenterological Association
- NIH [5TL1TR000098-05, EB001981]
- [K23-DK090303]
- [R01DK088925]
BackgroundTwo-dimensional magnetic resonance elastography (2D-MRE) is an advanced magnetic resonance method with high diagnostic accuracy for predicting advanced fibrosis in non-alcoholic fatty liver disease (NAFLD) patients. However, no prospective, head-to-head comparisons between 2D-MRE and clinical prediction rules (CPRs) have been performed in patients with biopsy-proven NAFLD. AimTo compare the diagnostic utility of 2D-MRE against that of eight CPRs (AST:ALT ratio, APRI, BARD, FIB-4, NAFLD Fibrosis Score, Bonacini cirrhosis discriminant score, Lok Index and NASH CRN model) for predicting advanced fibrosis in a prospective cohort with paired liver biopsy as the gold standard. MethodsThis is a cross-sectional analysis of a prospective study of 102 patients (58.8% women) with biopsy-proven NAFLD, 2D-MRE and clinical research assessment within 90days of biopsy. Receiver operating characteristic (ROC) analysis was performed to assess the performance of 2D-MRE and CPRs for predicting advanced fibrosis. ResultsThe mean (s.d.) age and BMI were 51.3 (+/- 14.0) years and 31.7 (+/- 5.5)kg/m(2) respectively. 48, 26, 9, 13 and 6 patients had stage 0, 1, 2, 3 and 4 fibrosis respectively. The area under ROC curve (AUROC) was 0.957 for 2D-MRE and between 0.796 and 0.861 for the CPRs. FIB-4 was the best-performing CPR at predicting advanced fibrosis with AUROC of 0.861. In head-to-head comparisons using the DeLong test, 2D-MRE had significantly better AUROC (P<0.05) than each CPR for predicting advanced fibrosis. ConclusionCompared to clinical prediction rules, 2D-MRE provides significantly higher accuracy for the diagnosis of advanced fibrosis in NAFLD patients.
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