| 车艳玲,蒋敏,徐皓煊,等.超声剪切波弹性成像在慢性乙型肝炎肝纤维化诊断中的应用[J].中国临床保健杂志,2022,25(5):682-685. |
| 超声剪切波弹性成像在慢性乙型肝炎肝纤维化诊断中的应用 |
| Application of ultrasonic shear wave elastography in the diagnosis of chronic hepatitis B liver fibrosis |
| 投稿时间：2022-03-07 |
| DOI：10.3969/J.issn.1672-6790.2022.05.023 |
| 中文关键词: 乙型肝炎 肝纤维化 弹性成像技术 超声检查 |
| 英文关键词: Hepatitis B Hepatic fibrosis Elasticity imaging techniques Ultrasonography 〖FL |
| 基金项目:黑龙江省自然科学基金面上项目(H2015018)；黑龙江省中医药科研项目(ZHY19-001) |
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| 中文摘要: |
| 目的 探讨超声剪切波弹性成像(SWE)在慢性乙型肝炎肝纤维化诊断中的应用价值。方法 回顾性分析2020年11月至2021年11月在黑龙江中医药大学附属第一医院住院治疗且经病理活检确诊为慢性乙型肝炎肝纤维化患者66例(CHB组),选取同期健康成年人50例(对照组),用SWE技术测量2组肝脏弹性模量(E)值,以病理检查CHB组结果的肝纤维化分期与对照组的SWE测值进行比较。运用Spearman进行相关性分析,受试工作特征(ROC)曲线评价分析超声SWE在慢性乙型肝炎肝纤维化中的诊断效能。结果 (1)对照组与CHB组的弹性模量值比较,差异有统计学意义。(2)慢性乙型肝炎肝纤维化分期F1期,F2 期,F3期,F4期的弹性模量值分别为(6.933±1.375) kPa (n=18)、(8.315±1.822) kPa (n=22)、(11.135±4.067) kPa (n=14)、(16.091±3.127) kPa (n=12),且各病理分期间弹性模量值比较,差异有统计学意义(F=33.463,P<0.001)。(3)肝脏弹性模量与肝纤维化病理分期具有相关性(r=0.760,P<0.001)。(4)以肝弹性模量值评估肝纤维化分期绘制ROC曲线,肝硬化分期≥F2期、≥F3期和F4期的ROC曲线下面积分别为0.852、0.903和0.965;根据最大约登指数确定的诊断界值分别为7.6、9.3和11.9 kPa。结论 超声SWE在无创评价慢性乙型肝纤维化程度中具有较可靠价值。 |
| 英文摘要: |
| Objective To investigate the value of ultrasonic shear wave elastography (SWE) in the diagnosis of chronic hepatitis B liver fibrosis.Methods Sixty-six patients (CHB group) with chronic hepatitis B liver fibrosis diagnosed by pathological biopsy in the First Affiliated Hospital of Heilongjiang University of Chinese Medicine from November 2020 to October 2021 were retrospectively analyzed.50 healthy adults (control group) were selected in the same period.The elastic modulus (E) of the liver was measured by SWE technique.The liver fibrosis stages of the CHB group were compared with elastic modulus of the control group.Spearman′s rho was used for correlation analysis,and the receiver operating characteristic (ROC) curve was used to evaluate the diagnostic efficacy of ultrasonic shear wave elastography in chronic hepatitis B liver fibrosis.Results (1)There was significant difference in elastic modulus between the control group and the CHB group.(2)The elastic modulus values of chronic hepatitis B liver fibrosis stages F1,F2,F3 and F4 were (6.933±1.375) kPa (n=18),(8.315±1.822) kPa (n=22),(11.135±4.067) kPa (n=14) and (16.091±3.127) kPa (n=12),respectively.The differences of elastic modulus among different pathological periods was statistically significant (F=33.463,P<0.001).(3)Liver elastic modulus was correlated with pathological stage of liver fibrosis (r=0.760,P<0.001).(4)Liver elastic modulus was used to evaluate liver fibrosis stage and ROC curve was plotted.The area under the ROC curve of liver fibrosis stages≥F2,≥F3 and F4 was 0.852,0.903 and 0.965,respectively.The diagnostic cutoff values determined by the most approximate index were 7.6 kPa,9.3 kPa and 11.9 kPa,respectively.Conclusion Ultrasonic SWE has reliable value in non-invasive evaluation of the degree of chronic hepatitis B liver fibrosis. |
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