瞬时弹性记录仪检测在脂肪肝筛查中的成功率及可靠性分析

Analysis of the Success Rate and Reliability of Fibroscan in Screening Fatty Liver

【目的】瞬时弹性记录仪已被各大肝病学会指南推荐为评估肝脏脂肪变性及肝硬度首选的无创检测工具,本研究旨在分析影响其检测成功率及结果可靠性的因素。【方法】2018年中山大学附属第一医院职工体检自愿接受检查且资料完整者共788例,分析年龄、性别、体质指数、腰围、操作者经验等对检测成功率及结果可靠性的影响。【结果】对脂肪肝的检出率高于B超(55.9%vs. 39.9%,P<0.001),总体检测失败及结果不可靠率仅为1.4%,检测成功率与性别无关,而随年龄、体质指数及腰围的增加而降低,LSM IQR/Median也随之呈现上升趋势,结果可靠性下降。随着操作次数增加,检测成功率及结果可靠性上升并趋于稳定,同一操作者进行超过300次检测可认为具备熟练操作经验。【结论】瞬时弹性记录仪的有效测量受增龄、体质指数、腰围等因素影响,固定操作者经短期培训后也能够获得很高的检测成功率及可靠的结果。

【Objective】Fibroscan has been recommended by multiple clinical guidelines as the first choice among the non-invasive tools for evaluating hepatic steatosis and liver stiffness. The study herein assessed the factors related to the success rate and reliability of the measurement.【Methods】A total of 788 volunteers from Year 2018′s staff physical checkup in The First Affiliated Hospital of Sun Yat-sen University were recruited. Relationship between age,gender,body mass index,waist circumference of the subjects,and the operator′s experience,and their effect on success rate and reliability were analyzed.【Results】had a higher detection rate for fatty liver as compared with ultrasound(55.9% vs.39.9%,P<0.001). Detection failure and unreliable measurements occurred in only 1.4% of all the participants. Success rate was not associated with gender,but decreased significantly with increased age,body mass index and waist circumference(P<0.05). LSM IQR/Median increased accordingly,thus reduced the reliability of the measurement.With accumulated number of measurements by the same operator,so did the success rate and reliability of the results. An operator with more than 300 measurements could be deemed as experienced operator.【Conclusions】The success rate and reliability of the measurement was affected by increased age,body mass index,waist circumference and operator′s experience. Fixed operator could also achieve very high success rate and reliable measurement using Fibroscan after shortterm training.