ASQ评价慢乙肝纤维化分期的研究  

Acoustic Structure Quantification(ASQ) Software in Estimating the Degree of Liver Fibrosis of Chronic Hepatitis B

作　　者：李明明[1] 朱梅[1] 

机构地区：[1]昆明医科大学第一附属医院超声科,云南昆明650032

出　　处：《昆明医科大学学报》2014年第8期54-59,共6页Journal of Kunming Medical University

基　　金：国家自然科学基金资助项目(81160178)

摘　　要：目的 初步研究声学结构定量（ASQ）技术在慢性乙型病毒性肝炎肝纤维化分期中的诊断价值.方法 收集在昆明医科大学第一附属医院超声科行肝脏穿刺活检的慢性乙型肝炎患者66例,所有受试者均于肝脏穿刺活检前进行超声常规检查及ASQ分析.应用ASQ技术分析肝实质回声的原始回波信号,记录并分析7个参数值：BR-Ratio（蓝红曲线下面积之比）、红、蓝曲线的各3个参数：Mode（众数）、Average（均数）、SD（标准差）.以病理学纤维化程度分期为金标准,分为S0 ～ S4 5组.将ASQ定量参数与病理肝纤维化程度进行相关性分析,对相关性较好的参数指标以肝纤维化程度S≥1、S≥2、S≥3、S≥4为不同研究终点分组进行受试者工作特征曲线（ROC）分析.结果 随着肝纤维化程度的增加,ASQ参数成像彩色编码图表现为肝脏实质回声增粗不均,红色区域增加,且不规则,黄绿色区减小,ASQ定量分析图表现为红曲线分布变窄,分布粗糙、增宽,蓝线峰值增大,曲线下面积增大.ASQ定量参数BR-Ratio值在各组之间均有显著性差异（P＜0.05）且与肝纤维化程度有较好正相关（r=0.772,P＜0.05）,对BR-Ratio值进行ROC分析,S≥1、S≥2、S≥3、S≥4时受试者特征曲线下面积（AUROC）分别为0.832、0.913、0.962、0.974.结论 ASQ技术是一种对基础回声信号的差异进行量化的技术,用于肝纤维化分期诊断是可行的,与病理学分级相关性好,在肝纤维化定量诊断中具有潜在的临床应用前景.Objective To assess the diagnostic accuracy of acoustic structure quantification （ASQ） ultrasound software in estimating the degree of liver fibrosis of chronic hepatitis B.Methods We selected 66 patients with histologically proven chronic hepatitis B virus,who were examined by B-Mode ultrasound with ASQ software before liver biopsy.We analyzed the original echo echo of liver parenchyma by application of ASQ technology,and recorded and analyzed the values of 7 parameters：BR-Ratio （area under the curve than the blue and red）,each of the 3 parameters of red,blue curve：Mode （mode） and Average （mean）,SD （standard deviation）.According to the pathological fibrosis staging which is the gold standard,patients were divided into five groups of S0-S4.The correlation between ASQ quantitative parameters of patients and pathological staging of liver fibrosis was analyzed.For well-correlation parameter,ROC was analyzed to get the optimal cutoff value for liver fibrosis S ≥ 1 and S ≥ 2 and S ≥ 3and S ≥ 4.Results Along with the increase of the degree of liver fibrosis,ASQ parameter imaging color coded map showed liver parenchymal hyperechoic uneven,the Red areas increased,and irregular,reduce the yellow green region,the quantitative analysis of ASQ image shows the red curve distribution becomes narrow,rough,wider distribution,the blue line peak increases,the area under the curve increases.The quantitative parameter BR-Ratio value in each group were much larger than the other six indicators and has a good positive correlation （r=0.772,P＜0.05）,The areas under ROC curves were 0.832 for S ≥ 1 and 0.913 for S ≥2 and 0.962 for S ≥ 3 and 0.974 for S ≥ 4.Conclusion ASQ is a technique for quantification of the difference in basic echo signal,is feasible in diagnosis and staging of liver fibrosis,and shows a good correlation with pathological grades,has potential clinical application prospect in quantitative diagnosis of liver fibrosis.

关 键 词：声学结构定量技术 肝纤维化 慢性乙型肝炎 

分 类 号：R512.62[医药卫生—内科学]