Osaki A, Kubota T, Suda T, Igarashi M, Nagasaki K, Tsuchiya A, Yano M, Tamura Y, Takamura M, Kawai H, Yamagiwa S, Kikuchi T, Nomoto M, Aoyagi Y. Shear wave velocity is a useful marker for managing nonalcoholic steatohepatitis. World J Gastroenterol 2010; 16(23): 2918-2925 [PMID: 20556839 DOI: 10.3748/wjg.v16.i23.2918]
Corresponding Author of This Article
Takeshi Suda, MD, PhD, Associate Professor, Department of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, 1-757 Asahimachi-dori, Chuo-ku, Niigata, Niigata 951-8122, Japan. suda@med.niigata-u.ac.jp
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Akihiko Osaki, Tomoyuki Kubota, Takeshi Suda, Masato Igarashi, Atsunori Tsuchiya, Masahiko Yano, Yasushi Tamura, Masaaki Takamura, Satoshi Yamagiwa, Minoru Nomoto, Yutaka Aoyagi, Department of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8122, Japan
Keisuke Nagasaki, Toru Kikuchi, Department of Homeostatic Regulation and Development, Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8122, Japan
Hirokazu Kawai, Department of Laboratory Medicine, Niigata University Medical and Dental Hospital, Niigata 951-8122, Japan
Author contributions: Osaki A and Kubota T contributed equally to this work; Kubota T and Suda T designed the research; Osaki A, Tsuchiya A, Yano M, Tamura Y, Takamura M, Kawai H and Yamagiwa S performed the research; Kubota T, Nagasaki K and Kikuchi T contributed to data manipulation; Igarashi M and Nomoto M contributed to histological evaluation; Suda T and Aoyagi Y analyzed the data; Suda T wrote the paper.
Correspondence to: Takeshi Suda, MD, PhD, Associate Professor, Department of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, 1-757 Asahimachi-dori, Chuo-ku, Niigata, Niigata 951-8122, Japan. suda@med.niigata-u.ac.jp
Telephone: +81-25-2272207 Fax: +81-25-2270776
Received: January 24, 2010 Revised: April 1, 2010 Accepted: April 8, 2010 Published online: June 21, 2010
Abstract
AIM: To investigate whether a noninvasive measurement of tissue strain has a potential usefulness for management of nonalcoholic steatohepatitis (NASH).
METHODS: In total 26 patients, 23 NASHs and 3 normal controls were enrolled in this study. NASH was staged based on Brunt criterion. At a region of interest (ROI), a shear wave was evoked by implementing an acoustic radiation force impulse (ARFI), and the propagation velocity was quantified.
RESULTS: Shear wave velocity (SWV) could be reproducibly quantified at all ROIs in all subjects except for 4 NASH cases, in which a reliable SWV value was not calculated at several ROIs. An average SWV of 1.34 ± 0.26 m/s in fibrous stage 0-1 was significantly slower than 2.20 ± 0.74 m/s and 2.90 ± 1.01 m/s in stages 3 and 4, respectively, but was not significantly different from 1.79 ± 0.78 m/s in stage 2. When a cutoff value was set at 1.47 m/s, receiver operating characteristic analysis showed significance to dissociate stages 3 and 4 from stage 0-1 (P = 0.0092) with sensitivity, specificity and area under curve of 100%, 75% and 94.2%, respectively. In addition, the correlation between SWV and hyaluronic acid was significant (P < 0.0001), while a tendency toward negative correlation was observed with serum albumin (P = 0.053).
CONCLUSION: The clinical implementation of ARFI provides noninvasive repeated evaluations of liver stiffness at an arbitrary position, which has the potential to shed new light on NASH management.
