当前位置： SCI文献检索 > EUROPEAN RADIOLOGY期刊下所有文献 > Comparison of three cut-offs to diagnose clinically significant portal hypertension by liver stiffness in chronic viral liver diseases: a meta-analysis.

Comparison of three cut-offs to diagnose clinically significant portal hypertension by liver stiffness in chronic viral liver diseases: a meta-analysis.

Abstract：

BACKGROUND:Transient elastography-based liver stiffness value (TE-LSV) has been investigated for assessing clinically significant portal hypertension (CSPH). The aetiology of CSPH is an important factor determining TE-LSV. There is insufficient evidence for selecting cut-off values. AIMS:This study performed a meta-analysis to compare the three most widely used cut-off values (around 13.6 kPa, 18 kPa and 22kPa) of TE-LSV for the diagnosis of CSPH in patients with chronic viral liver disease. METHODS:The PubMed, Ovid, Web of Science and Cochrane Library databases were searched. Diagnostic data for cut-off values around 13.6 kPa, 18 kPa and 22 kPa in each included study were extracted. The bivariate model was performed to estimate pooled sensitivity, specificity, positive likelihood ratio (LR+) and negative likelihood ratio (LR-). RESULTS:Eleven studies assessing 910 patients were included in this meta-analysis. Pooled sensitivities of cut-off values around 13.6 kPa, 18 kPa and 22 kPa were 0.96 (95% CI 0.93-0.97), 0.85 (0.81-0.89) and 0.74 (0.66-0.80), respectively; pooled specificities were 0.60 (0.47-0.75), 0.80 (0.71-0.87) and 0.94 (0.86-0.97), respectively. Pooled LR+ values were 2.4 (1.6-3.7), 4.4 (2.9-6.8) and 11.5 (5.5-23.5) for cut-off values around 13.6 kPa, 18 kPa and 22 kPa, respectively, for pooled LR- values of 0.07 (0.04-0.13), 0.17 (0.12-0.25) and 0.28 (0.22-0.36), respectively. CONCLUSION:Cut-off values around 13.6 kPa (high sensitivity) and 22 kPa (high specificity) could be used as screening and confirmation tools, respectively, in the diagnosis of CSPH. Overall, the cut-off value around 22 kPa showed the best performance. KEY POINTS:Transient elastography-based liver stiffness could be used to diagnose portal hypertension. Comparison of certain cut-off values would provide more information for clinical decision-making. Cut-off around 13.6 kPa was able to exclude clinically significant portal hypertension (CSPH) effectively. Cut-off around 22 kPa was able to confirm CSPH effectively.

journal_name

Eur Radiol

journal_title

European radiology

authors

Song J,Ma Z,Huang J,Liu S,Luo Y,Lu Q,Schwabl P,Zykus R,Kumar A,Kitson M

doi

10.1007/s00330-018-5478-z

subject

Has Abstract

pub_date

2018-12-01 00:00:00

pages

5221-5230

issue

eissn

0938-7994

issn

1432-1084

pii

10.1007/s00330-018-5478-z

journal_volume

pub_type

杂志文章,meta分析

在线工具

Comparison of three cut-offs to diagnose clinically significant portal hypertension by liver stiffness in chronic viral liver diseases: a meta-analysis.