实时剪切波弹性成像技术在慢性乙型肝炎肝纤维化程度定量评估中的临床研究
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A clinical study of real-time shear wave elastography for quantitative assessment of liver fibrosis in chronic hepatitis B patients
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    目的:探讨应用实时剪切波弹性成像(real-time shear wave elastography,SWE)在慢性乙型肝炎肝纤维化程度评价中的应用价值。方法:将SWE应用于60例健康对照者-68例慢性乙型肝炎患者行肝脏弹性模量检测,并对68例慢性乙肝患者进行肝穿刺活组织检查,以病理检查结果的纤维化分期与肝脏的SWE测值进行比较。结果:健康对照组与肝纤维化组的弹性模量值比较差异有统计学意义,慢性乙型肝炎肝纤维化分期S1期-S2期-S3期-S4期的弹性模量值分别为(7.171 ± 1.819)kPa(n=14)-(10.300 ± 3.121)kPa(n=18)-(15.540 ± 4.341)kPa(n=20)-(23.919 ± 5.698)kPa(n=16)。各病理分期间弹性模量差异具有统计学意义(F=50.807,P < 0.001)。肝弹性模量与肝纤维化病理分期具有相关性(r=0.783,P < 0.001)。 以肝弹性模量判断肝纤维化分期绘制受试者操作特性曲线 ,肝硬化分期≥S2-≥S3和S4的受试者工作特征曲线下面积分别为0.940-0.947和0.949。结论:SWE技术对慢性乙型肝炎肝纤维化程度有一定的诊断效能,具有潜在的临床实用价值。

    Abstract:

    Objective:To investigate the diagnostic value of real-time shear wave elastography(SWE)technology for the assessment of liver fibrosis in chronic hepatitis B (CHB)patients. Methods:Hepatic elastic modulus of 60 health control people and 68 patients with CHB were measured by SWE,and 68 patients had liver biopsy. The elastic modulus was compared with pathological stages of hepatic fibrosis. Results:The modulus of elasticity had a statistically significant difference in health control people and liver fibrosis patients. The elastic modulus of each pathological stages of hepatic fibrosis included S1 at (7.171 ± 1.819)kpa (n=14),S2 at(10.300 ± 3.121)kPa(n=18),S3 at(15.540 ± 4.341)kPa(n=20),and S4 at(23.919 ± 5.698)kPa(n=16). The elastic modulus of each pathological stages had statistically significant difference (F=50.807,P < 0.001). The elastic modulus was correlated with pathological stages in a correlation coefficient of 0.783 (P < 0.001). The ROC curve was set up by evaluating the pathological stages through elastic modulus. Areas under ROC curve of 0.940 for ≥S2 patients,of 0.947 for ≥S3 patients,of 0.949 for S4 patients. Conclusion:SWE has certain diagnostic efficiency in evaluating liver fibrosis stage in CHB patients.

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毛翠莲,林红军,巩海燕.实时剪切波弹性成像技术在慢性乙型肝炎肝纤维化程度定量评估中的临床研究[J].南京医科大学学报(自然科学版),2015,(8):1142-1145

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  • 收稿日期:2014-11-30
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  • 在线发布日期: 2015-08-04
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