Diagnostic accuracy of 2D-SWE ultrasound for liver fibrosis assessment in MASLD: A multilevel random effects model meta-analysis.

Early detection of advanced fibrosis and cirrhosis in MASLD is essential due to their unfavorable outcomes.

由于其不良的预后，早期检测MASLD中的高级纤维化和肝硬化至关重要。

This multilevel random-effects meta-analysisaimed to provide the best evidence for the diagnostic accuracy of 2-dimensional shear wave elastography in detecting liver fibrosis in biopsy-proven MASLD.

这项多层次随机效应的荟萃分析旨在提供二维剪切波弹性成像在检测活检证实的MASLD患者肝纤维化诊断准确性方面的最佳证据。

approach_and_results

This study involves systematic search in PubMed/MEDLINE, Embase, Scopus, Web of Science, LILACS, and Cochrane Library electronic databases for full-text articles published in any language up to February 26, 2024.

本研究涉及在PubMed/MEDLINE、Embase、Scopus、Web of Science、LILACS和Cochrane Library电子数据库中进行系统检索，以获取截至2024年2月26日以任何语言发表的全文文章。

Included studies reported liver stiffness measurement by 2-dimensional shear wave elastography and used histological diagnosis as the gold standard.

纳入的研究报告了通过二维剪切波弹性成像测量肝脏硬度，并使用组织学诊断作为金标准。

A linear mixed-effects multiple thresholds model was employed, and summary estimates for sensitivity, specificity (Sp), and summary area under the receiver operator characteristic curve were computed.

采用线性混合效应多阈值模型，并计算了敏感性、特异性（Sp）和总结接收者操作特征曲线下面积的汇总估计值。

Twenty observational studies (SuperSonic Imagine, General Electric Healthcare, and Canon Medical Systems) fulfilled the inclusion criteria, comprising 2223 participants with biopsy-proven MASLD.

20项观察性研究（SuperSonic Imagine、通用电气医疗保健和佳能医疗系统）符合纳入标准，包括2223名经活检证实的MASLD患者。

The prevalenceof mild fibrosis (F1), significant fibrosis (F2), advanced fibrosis (F3), and cirrhosis (F4) was 30.0%, 18.5%, 17.9%, and 10.9%, respectively.

轻度纤维化（F1）、显著纤维化（F2）、晚期纤维化（F3）和肝硬化（F4）的患病率分别为30.0%、18.5%、17.9%和10.9%。

The summary area under the receiver operator characteristic curve [95% CI] in detecting ≥F1, ≥F2, ≥F3, and F4 for all ultrasound machines considered together were 0.82 [0.16-0.98], 0.82 [0.76-0.88], 0.86 [0.77-0.93], and 0.89 [0.80-0.95], respectively.

综合考虑所有超声设备，在检测≥F1、≥F2、≥F3和F4时，汇总的接收者操作特征曲线下面积[95%置信区间]分别为0.82 [0.16-0.98]、0.82 [0.76-0.88]、0.86 [0.77-0.93]和0.89 [0.80-0.95]。

The optimal cutoff values were 6.432 kPa for ≥F1, 8.174 kPa for ≥F2, 9.418 kPa for ≥F3, and 11.548 kPa for F4, respectively.

最佳截断值分别为≥F1的6.432 kPa，≥F2的8.174 kPa，≥F3的9.418 kPa，以及F4的11.548 kPa。

Conclusions

Our meta-analysisidentified optimized cutoffs for fibrosis staging by 2-dimensional shear wave elastography in etiology-specific chronic liver diseases (MASLD), with excellent diagnostic performance, underscoring the potential for standardizing cutoff values.

我们的荟萃分析确定了病因特异性慢性肝病（MASLD）中二维剪切波弹性成像纤维化分期的优化临界值，具有出色的诊断性能，强调了标准化临界值的潜力。