【摘要】 目的探讨影像引导瞬时弹性成像系统Fibro Touch脂肪衰减参数(FAP)对脂肪肝诊断的意义。方法以2014年1月-12月在中国医科大学附属第一医院体检的1080例体检者为研究对象,统计所有人员的肝脏FAP、肝脏彩超结果和肝脏CT平扫肝/脾CT比值。计量资料组间比较采用Kruskal-Wallis H检验,采用Kappa一致性系数和ROC曲线比较FAP与肝脏彩超结果和肝脏CT平扫肝/脾CT比值诊断脂肪肝的一致性及其诊断价值。结果通过肝脏B超诊断脂肪肝阴性336例(31.11%),阳性744例(68.89%);参照B超结果,Fibro Touch的敏感性及特异性分别为80.5%和75.3%。通过肝脏CT诊断脂肪肝阴性(0级)821例(76.02%)、阳性259例,其中轻度(1级)216例、中度(2级)34例、重度(3级)9例;参照CT结果,Fibro Touch的敏感性及特异性分别为95.4%和47.0%,B超的敏感性及特异性分别为93.1%和36.8%。Fibro Touch诊断脂肪肝结果与B超有较高的一致性(kappa系数=0.597,P<0.0001);与CT的一致性较低(Kappa系数=0.113,P<0.0001)。结论 Fibro Touch诊断脂肪肝准确、方便、无创、费用低,是临床最具优势的诊断脂肪肝的影像学检测方法。更多还原

【Abstract】 Objective To investigate the clinical significance of image- guided transient elastography Fibro Touch with fat attenuation parameter( FAP) in the diagnosis of fatty liver disease. Methods A total of 1080 persons who underwent physical examination in The First Affiliated Hospital of China Medical University from January to December,2014 were enrolled,and liver FAP,the results of color Doppler ultrasound for the liver,and liver / spleen CT ratio on computed tomography( CT) scan for the liver were collected and analyzed. The Kruskal- Wallis H test was applied for comparison of continuous data between groups,and the Kappa consistency coefficient and receiver operating characteristic curve were used to investigate the consistency between FAP and the results of color Doppler ultrasound for the liver or liver / spleen CT ratio on CT scan for the liver in the diagnosis of fatty liver disease and their diagnostic values. Results Liver ultrasound found 336 patients( 31. 11%) without fatty liver disease and 744 patients( 68. 89%) with fatty liver disease; with reference to the results of ultrasound,the sensitivity and specificity of Fibro Touch were 80. 5% and 75. 3%,respectively. Liver CT found 821 patients( 76. 02%)without fatty liver disease( grade 0) and 259 patients with fatty liver disease,among whom 216 had mild fatty liver disease( grade 1),34 had moderate fatty liver disease( grade 2),and 9 had severe fatty liver disease( grade 3); with reference to the results of liver CT,the sensitivity and specificity of Fibro Touch were 95. 4% and 47. 0%,respectively,and the sensitivity and specificity of ultrasound were 93. 1%and 36. 8%,respectively. As for the diagnosis of fatty liver disease,the results of Fibro Touch had a higher consistency with ultrasound results( Kappa coefficient = 0. 597,P < 0. 0001),and a lower consistency with CT results( Kappa coefficient = 0. 113,P < 0. 0001). Conclusion Fibro Touch has the advantages of high accuracy,easy operation,noninvasiveness,and low cost,and therefore it is a promising imaging method for the diagnosis of fatty liver disease.更多还原