论文标题

脂肪和纤维化是肝脏粘弹性测量中的混杂辅因子

Fat and fibrosis as confounding cofactors in viscoelastic measurements of the liver

论文作者

Poul, Sedigheh S., Parker, Kevin J.

论文摘要

弹性图提供了有关肝病患者纤维化分期的重要信息,并且在评估脂肪变性方面可能具有一定价值。然而,关于脂肪变性和纤维化的作用仍然存在问题,因为辅助因子影响了肝组织的粘弹性测量值,尤其是剪切波速度(SWS)和剪切波衰减(SWA)。在这项研究中,通过采用复合弹性培养基理论以及对脂肪中明智素幻像的两种独立的实验测量以及有限的元素模拟,始终表明脂肪和纤维化会共同影响SWS和SWA测量。在恒定水平的脂肪水平下,纤维化阶段可以通过2-4的因素影响SWA。此外,随着脂肪的增加,SWA的增加速率受纤维化阶段的强烈影响。较软的背景病例(低纤维化阶段)与具有更硬模量的脂肪(纤维化阶段更高)相比,SWA的脂肪含量更高。同时,SWS结果受脂肪的存在影响,但是可变性程度更加微妙。结果表明,共同考虑脂肪和纤维化是对复杂肝组织中SWS和SWA测量的贡献以及临床试验的设计和解释的重要性。

Elastography provides significant information on staging of fibrosis in patients with liver disease and may be of some value in assessing steatosis. However, there remain questions as to the role of steatosis and fibrosis as cofactors influencing the viscoelastic measurements of the liver tissues, particularly shear wave speed (SWS) and shear wave attenuation (SWA). In this study, by employing the theory of composite elastic media as well as two independent experimental measurements on fat-in-gelatin phantoms and also finite element simulations, it is consistently shown that fat and fibrosis jointly influence the SWS and SWA measurements. At a constant level of fat, fibrosis stages can influence the SWA by factors of 2-4. Moreover, the rate of increase in SWA with increasing fat is strongly influenced by the stages of fibrosis; softer background cases (low fibrosis stages) have higher rate of SWA increase with fat than those with stiffer moduli (higher fibrosis stages). Meanwhile, SWS results are influenced by the presence of fat, however the degree of variability is more subtle. The results indicate the importance of jointly considering fat and fibrosis as contributors to SWS and SWA measurements in complex liver tissues and in the design and interpretation of clinical trials.

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