乙肝病毒携带者声脉冲辐射力成像检测的临床价值研究  

Acoustic radiation force impulse imaging in evaluation of asymptomatic hepatitis B viral carriers

作　　者：钱云松[1] 

机构地区：[1]宁波市第二医院消化四科,315010

出　　处：《浙江医学》2013年第2期114-115,130,共3页Zhejiang Medical Journal

摘　　要：目的了解声脉冲辐射力成像（ARFI）对乙肝病毒携带者（ASC）肝纤维化及炎症程度的诊断价值。方法选择352例ASC住院患者，进行ARFI检查和肝穿刺活体组织检查，并分析ARFI检测结果与肝组织纤维化及炎症程度的关系。结果352例患者中肝组织无明显病理变化（G。S。）26例（7．3％）；表现为慢性肝炎319例（90．6％），其中轻度（G1-2S0-2）、中度（G。S。）和重度（G。S。）分别为208、81和30例；肝硬化7例（2．0％）。病理正常组的剪切波速度为（124±0．11）m／s，轻度慢性肝炎组（1．354-0．28）m／s，中度慢性肝炎组（1．864-0．59）m／s，重度慢性肝炎组（1．984-0．53）m／s，肝硬化组（2524-037）m／s。多数ASC患者有不同程度病理变化，除了正常组和轻度慢性肝炎组，剪切波速度在肝炎各组比较差异均有统计学意义（均P〈001），而且与病理损伤级别呈正相关。结论ARFI对明确ASC患者肝纤维化及炎症程度的诊断具有一定临床价值。Objective To investigate the diagnostic value of acoustic radiation force impulse （ARFI） imaging in evaluation of fibrosis and inflammation in asymptomatic hepatitis B viral carrier （ASC）. Methods Three hundred and fifty two cases of ASC underwent ARFI imaging examination and liver puncture biopsy. The correlation of APRF findings and the degree of fibrosis and inflammation in liver tissue was analyzed. Results Liver biopsy showed that among 352 cases 26 （7.3%） had no significant pathological changes in liver tissue （GoSo）; 319 （90.6%） had chronic hepatitis, including 208 mild cases （G1-2S0-2）, 81 moderate cases （G3S1-3） and 30 severe cases （G4S2-4）; there were 7 cases of cirrhosis （2.0%）. The shear wave velocity of pathological normal group was （1.24 ± 0.11）m/s, that of mild chronic hepatitis was （1.35± 0.28） m/s, that of moderate chronic hepatitis was （1.86 ±0.59）m/s, that of severe chronic hepatitis was （1.98± 0.53）m/s; that of liver cirrhosis was （2.52 ± 0.37） m/s. Majority of ASC had certain degree of pathological changes, there were statistical differences in shear wave velocity among different groups, except the normal and mild chronic hepatitis groups, （P〈0.01）. The shear wave velocity was positively related to the degrees of patho- logical injury. Conclusion ARFI has certain clinical value in evaluating degree of fibrosis and inflammation in asymptomatic hep- atitis B viral carriers.

关 键 词：乙肝病毒携带者 声脉冲辐射力成像 肝穿刺 剪切波 

分 类 号：R512.62[医药卫生—内科学]