【摘要】 目的:研究影像引导瞬时弹性成像系统(Fibro Touch,FT)的脂肪衰减参数(FAP)在慢性乙型肝炎合并肝脂肪变早期诊断的意义。方法:以2018年5-12月在江门市中心医院体检中心和门诊就诊的慢性乙型肝炎患者120例为研究对象,分别统计分析CT计算得到的肝脾比值、B超诊断结果和FT检查肝脏所得FAP值。同时,为保证Kappa一致性和ROC曲线值的一致性,分别对照FAP值、B超结果及采用肝脾比值诊断肝脂肪变并评估其诊断价值。结果:B超诊断肝脂肪变阴性37例(30.83%),阳性83例(69.17%);参照B超结果,得到FT检测的敏感性和特异性分别为73.9%、79.7%。CT诊断肝脂肪变阴性91例(75.83%)、阳性29例(24.17%),轻度(1级)24例(20.00%)、中度(2级)4例(3.33%)、重度(3级)1例(0.83%);参照CT结果,FT检测的敏感性和特异性分别为46.4%、94.4%,B超检查的敏感性和特异性分别为38.8%、91.4%。FT诊断肝脂肪变结果与B超有较高的一致性(Kappa系数=0.522,P<0.000 1),但与CT的一致性较低(Kappa系数=0.272,P<0.000 1)。结论:FT在早期诊断慢性乙型肝炎合并肝脂肪变的临床应用中,具有操作简单、结果准确、对患者无创、且检测成本低,因此FT是一种在临床早期诊断慢性乙型肝炎合并肝脂肪变领域极具有广泛应用前景的检测技术。更多还原

【Abstract】 Objective:To investigate the clinical value of Fibro Touch-elastography image guiding transiently system,FT-with fat attenuation parameter(FAP)in the early diagnosis of Chronic hepatitis B with hepatic steatosis.Method:120 patients with chronic hepatitis B who visited the physical examination center and outpatient clinic of Jiangmen Central Hospital from May to December 2018 were selected as the study subjects.The ratio of liver to spleen calculated by CT,the diagnostic results of B-mode ultrasonography and the FAP value of liver examined by FT were analyzed.At the same time,in order to ensure the consistency of Kappa and ROC curves,the diagnostic value of FAP,B-mode ultrasonography and liver-spleen ratio for hepatic steatosis were evaluated.Result:B-mode ultrasonography of hepatic steatosis was negative in 37 cases(30.83%) and positive in 83 cases(69.17%).The sensitivity and specificity of FT were 73.9% and 79.7% according to the results of B-mode ultrasonography.CT diagnosis of liver steatosis was negative in 91 cases(75.83%),positive in 29 cases(24.17%),mild(grade 1) in 24 cases(20.00%),moderate(grade 2)in 4 cases(3.33%)and severe(grade 3)in 1 case(0.83%).According to CT results,the sensitivity and specificity of FT were 46.4% and 94.4%respectively,and that of B-mode ultrasonography were 38.8% and 91.4%.The results of FT diagnosis of hepatic steatosis were in good agreement with those of B-mode ultrasonography(Kappa coefficient=0.522,P<0.0001),but not with CT(Kappa coefficient=0.272,P<0.000 1).Conclusion:Fibro Touch has an advantages of high easy-operate,accuracy,noninvasiveness,low cost,and consequently,it is a promising early diagnosis technique of hepatic steatosis.更多还原