Abstract

PurposeTo evaluate the accuracy of shear wave elastography (SWE) in the quantitative diagnosis of liver fibrosis severity.MethodsThe published literatures were systematically retrieved from PubMed, Embase, Web of science and Scopus up to May 13th, 2016. Included studies reported the pooled sensitivity, specificity, positive and negative predictive values, as well as the diagnostic odds ratio of SWE in populations with liver fibrosis. A bivariate mixed-effects regression model was used, which was estimated by the I2 statistics. The quality of articles was evaluated by quality assessment of diagnostic accuracy studies (QUADAS).ResultsThirteen articles including 2303 patients were qualified for the study. The pooled sensitivity and specificity of SWE for the diagnosis of liver fibrosis are as follows: ≥F1 0.76 (p<0.001, 95% CI, 0.71–0.81, I2 = 75.33%), 0.92 (p<0.001, 95% CI, 0.80–0.97, I2 = 79.36%); ≥F2 0.84 (p = 0.35, 95% CI, 0.81–0.86, I2 = 9.55%), 0.83 (p<0.001, 95% CI, 0.77–0.88, I2 = 86.56%); ≥F3 0.89 (p = 0.56, 95% CI, 0.86–0.92, I2 = 0%), 0.86 (p<0.001, 95% CI, 0.82–0.90, I2 = 75.73%); F4 0.89 (p = 0.24, 95% CI, 0.84–0.92, I2 = 20.56%), 0.88 (p<0.001, 95% CI, 0.84–0.92, I2 = 82.75%), respectively. Sensitivity analysis showed no significant changes if any one of the studies was excluded. Publication bias was not detected in this meta-analysis.ConclusionsOur study suggests that SWE is a helpful method to appraise liver fibrosis severity. Future studies that validate these findings would be appropriate.

Highlights

  • Liver fibrosis is a diffuse excessive deposition of extracellular matrix especially collagen material in the liver, which is a repair response mechanism after chronic liver injury of various causes [1]

  • Thirteen articles including 2303 patients were qualified for the study

  • Our study suggests that shear wave elastography (SWE) is a helpful method to appraise liver fibrosis severity

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Summary

Introduction

Liver fibrosis is a diffuse excessive deposition of extracellular matrix especially collagen material in the liver, which is a repair response mechanism after chronic liver injury of various causes [1]. The liver biopsy remains as the gold standard to measure fibrosis as it offers precise diagnostic information, it could lead to various complications [2]. Real-time shear wave elastography (SWE) that was first reported by Bercoff J et al in 2004, is a twodimensional transient elastography technique based on the principle of Mach Cones for noninvasive evaluation of liver fibrosis [5, 6]. The key of the image is shear wave from radiation force generated by an amplitude modulated beam of focused ultrasound. These waves are detected by a proper imaging modality [7]. Liver fibrosis has a greater elastic coefficient than the normal hepatic tissue

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