声辐射力脉冲技术和天门冬氨酸氨基转移酶与血小板比值指数评价家兔肝纤维化  

Acoustic radiation force impulse and aspartate aminotransferase to platelet ratio index for evaluation of liver fibrosis in rabbits

作　　者：王蕊[1] 马苏美[1] 张晓媛[1] 姚亚宁[1] 杨东红[1] 冯菲[1] 

机构地区：[1]兰州大学第一医院超声科,甘肃兰州730000

出　　处：《中国医学影像技术》2014年第3期329-333,共5页Chinese Journal of Medical Imaging Technology

摘　　要：目的探讨声辐射力脉冲(ARFI)技术和天门冬氨酸氨基转移酶与血小板比值指数(APRI)评价家兔肝纤维化模型的价值。方法应用硫代乙酰胺(TAA)对32只家兔以皮下注射的方法建立肝纤维化模型,以8只家兔作为对照组。于首次注射后第4、8、12周分批应用ARFI获取剪切波速度(SWV),计算APRI,取其肝脏行病理肝纤维化分期。以病理检查结果为金标准,比较SWV和APRI指数对家兔肝纤维化分期的诊断价值。结果共29只家兔造模成功,其中肝纤维化分期为S1、S2、S3和S4期者分别为10、8、7和4只。SWV值和APRI均随纤维化程度加重而增高(P<0.05)。SWV(r=0.724,P<0.05)和APRI(r=0.555,P<0.05)与肝纤维化病理分级均存在相关性。SWV和APRI诊断家兔肝纤维化S≥1、S≥2、S≥3、S=4的ROC曲线下面积分别为0.92、0.81,0.87、0.78,0.82、0.76,0.89、0.79。SWV和APRI联合诊断S≥3的AUC为0.84,敏感度为81.80%,特异度为73.10%,阳性预测值为56.23%,阴性预测值为90.48%。结论ARFI技术与APRI可定量评估家兔肝纤维化程度,ARFI技术的价值较高。Objective To assess the value of acoustic radiation force impulse （ARFI） elastography and AST to platelet ratio index （APRI） for staging liver fibrosis in rabbit models. Methods Liver fibrosis models （model group） were established in 32 rabbits by subcutaneously infusing thioacetamide （TAA）, 8 rabbits were enrolled as control group. Some rabbits in model group and the control group were randomly selected and underwent ARFI elastography in order to obtain the shear wave velocity （SWV） respectively at the 4th, 8th and 12th week after the first injection. APRI was calculated though routine biochemical examination, and the rabbit＇s liver were taken for pathology analysis. Taking histopathological staging of liver fibrosis as golden standards, the diagnostic performance of SWV and APRI were compared using ROC curve analysis. Results Liver fibrosis models were successfully established in 29 rabbits, among them 10, 8, 7 and 4 were classified as S1, S2, S3 and S4 of liver fibrosis by pathology, respectively. The mean value of SWV and APRI increased with the exacerbation of liver fibrosis （P〈0.05）. SWV （r=0.724, P〈0.05） and APRI （r=0.555, P〈0.05） showed correlation with fibrosis. The area under tROC curves for SWV and APRI was 0.92 and 0.81 for S≥1, 0.87 and 0.78 for S≥2, 0.82 and 0.76 for S≥3, 0.89 and 0.79 for S=4, respectively. The area under ROC curves for combination SWV and APRI in the diagnosis of S≥3 was 0.84, for the sensitivity was 81.80%, the specificity was 73.10%, the positive predictive value was 56.23%, the negative predictive value was 90.48%. Conclusion Both ARFI and APRI can provide accurate quantitative evaluation of liver fibrosis in rabbits. ARFI is better than APRI for diagnosis of liver fibrosis.

关 键 词：肝纤维化 兔 声辐射力脉冲 弹性成像技术 

分 类 号：R332[医药卫生—人体生理学] R445.1[医药卫生—基础医学]