【摘要】 目的分析超声实时组织弹性成像(RTE)定量分析对慢性乙型肝炎肝纤维化程度的诊断价值。方法2015年7月~2016年12月在我院就诊的175例慢性乙型肝炎患者和同期门诊体检无异常的100例健康人,行肝活检和彩色多普勒超声检查。应用受试者工作特征曲线(ROC)分析指标的诊断效能。结果健康人平均相对应变值(ARV)为(128.3±8.1),显著高于慢性乙型肝炎患者【(106.3±5.2),P<0.05】,健康人蓝色面积百分比(AREA)、复杂度(COMP)、偏度(SKEW)、对比度(CONT)和杂乱度(IDM)分别为(31.0±3.5)、(16.6±1.2)、(-0.1±0.0)、(91.8±9.1)、(0.1±0.0),均显著低于慢性乙型肝炎患者【(48.9±4.8)、(29.4±3.1)、(0.3±0.1)、(173.9±17.9)、(0.2±0.1),P<0.05】;67例S0-S1组ARV为(118.5±5.6),显著高于83例S2-S3组的(101.6±5.3),也显著高于26例S4组的【(89.7±4.9),P<0.05】;S0-S1组AREA、COMP、SKEW、CONT和IDM分别为、(9.4±1.7)、(22.4±2.4)、(0.11±0.0)、(121.0±11.2)、(0.1±0.0),显著低于S2-S3组的【(23.5±2.4)、(31.8±2.7)、(0.32±0.1)、(188.2±15.2)、(0.2±0.1),均P<0.05】;S2-S3组AREA、COMP、SKEW和CONT均显著低于S4组的【(36.2±2.6)、(40.1±2.9)、(0.46±0.1)、(265.3±16.1),均P<0.05】;ROC曲线分析显示,ARV、AREA和SKEW均对S0-S1、S2-S3和S4有诊断价值,AUC面积均大于0.5。结论超声实时组织弹性成像定量分析无创诊断慢性乙型肝炎患者肝纤维化程度有一定的判断意义,可作为肝纤维化检查的方法之一应用于临床。更多还原

【Abstract】 Objective To analyze the diagnostic value of quantitative analysis of liver fibrosis by real time tissue elastography in patients with hepatitis B. Methods 175 patients with hepatitis B and 100 healthy persons between July 2015 and December 2016 were recruited in our hospital,and liver biopsies were performed in patients with hepatitis B. Real-time tissue elastography(RTE) was conducted in the two groups. The receiver operating characteristic curve(ROC) was used to analyze the efficacy of diagnostic value of each parameter. When the area under curve(AUC) of ROC was greater than 0.5,the diagnosis was set up. R esults The average relative value(ARV) in health group was(128.3±8.1),much higher than(106.3±5.2) in CHB patients(P<0.05);the area ratio of low-strain region(AREA),complexity(COMP),skewness(SKEW),contrast(CONT) and inverse different moment(IDM) in health group were(3.7±0.5),(16.6±1.2),(-0.1±0.0),(91.8±9.1),(0.1±0.0),much lower than[(19.9 ±2.6),(29.4 ±3.1),(0.3 ±0.1),(173.9 ±17.9),(0.2 ±0.1),all P <0.05) in patients with CHB;the ARV in 67 patients with S0-S1 staging was(118.5±5.6),much higher than [(101.6±5.3),P<0.05] in 82 with S2-S3,and also much higher than [(89.7±4.9),P<0.05] in 26 with S4 staging;the AREA,COMP,SKEW,CONT and IDM in S0-S1 group were(9.4 ±1.7),(22.4 ±2.4),(0.11 ±0.0),(121.0±11.2),(0.1±0.0),much lower than [(23.5±2.4),(31.8 ±2.7),(0.32 ±0.1),(188.2 ±15.2),(0.2 ±0.1),all P<0.05) in S2-S3 group,and the AREA,COMP,SKEW,CONT in S2-S3 group were also much lower than [(36.2 ±2.6),(40.1 ±2.9),(0.46 ±0.1),(265.3±16.1),all P<0.05) in S4 group;ROC curve analysis showed that the ARV,AREA and SKEW had diagnostic value for diagnosis of S0-S1,S2-S3 and S4 as the AUC were greater than 0.5. Conclusion Non invasive diagnosis of quantitative analysis by real time tissue elastography has diagnostic significance for liver fibrosis in patients with hepatitis B,and it might be used as one of the alternative methods for liver fibrosis.更多还原