脾剪切波速度与肝硬化食管静脉曲张破裂出血的关系  

Relationship between shear wave velocity of spleen and esophageal varicosity bleeding in patients with liver cirrhosis

作　　者：张明琼[1,2] 冉海涛[1,2] 曹小玲[1,2] 李攀[1,2] 王志刚[1,2] 

机构地区：[1]重庆医科大学超声影像学研究所,重庆400010 [2]重庆医科大学附属第二医院超声科,重庆400010

出　　处：《中国医学影像技术》2013年第10期1661-1664,共4页Chinese Journal of Medical Imaging Technology

基　　金：国家自然科学基金(81071157);重庆市科技攻关重点项目(2009AB5216)

摘　　要：目的探讨脾剪切波速度(SWV)对肝硬化食管静脉曲张破裂出血(EVB)的预测价值。方法应用声触诊组织量化(VTQ)技术测量99例受试者的脾SWV值,包括69例乙肝后肝硬化患者(出血组36例、非出血组33例)和30名健康志愿者(对照组),比较各组脾SWV值的差异,分析脾SWV值与EVB的关系。结果脾SWV值在各组间差异均有统计学意义(P均<0.05);脾SWV值与EVB发生率呈正相关(r=0.68,P<0.05);脾SWV值诊断EVB的临界值为3.54m/s,敏感度、特异度分别为81.3%、84.6%,ROC曲线下面积为0.89。结论 VTQ技术测量的脾SWV值可用于预测肝硬化患者EVB的风险,具有重要临床应用价值。Objective To explore the predictive value of spleen shear wave velocity （SWV） on esophageal varicosity bleeding （EVB） in patients with liver cirrhosis. Methods Spleen SWV was measured with virtual touch tissue quantification （VTQ） technique in 99 subjects, including 69 patients with hepatitis B cirrhosis （36 patients of the bleeding group, 33 patients of non-bleeding group） and 30 healthy volunteers （normal control group）. Spleen SWV was compared among three groups, and the relationship between Spleen SWV and EVB was analyzed. Results There were significant differences among the bleeding group, non-bleeding group and normal control group （all P〈0.05）. A significant linear correlation was found between Spleen SWV and EVB （r=0.68, P〈0.05）. The cut-off value of spleen SWV for predicting the presence of EVB was 3.54 m/s, and the area under ROC curve was 0.89, with the sensitivity and specificity of 81.3% and 84.6%, respectively. Conclusion Spleen SWV measured by VTQ technique can be used to predict the risk of EVB in patients with liver cirrhosis, having important clinical value.

关 键 词：超声检查 声触诊组织量化 剪切波速度 肝硬化 脾 食管和胃静脉曲张 出血 

分 类 号：R575.2[医药卫生—消化系统] R445.1[医药卫生—内科学]