速度向量成像技术对肝纤维化诊断价值的初步研究  

PRELIMINARY RESEARCH OF VELOCITY VECTOR IMAGE IN THE DIAGNOSTIC OF HEPATIC FIBROSIS

作　　者：马晓鸣 张树华 李晶[3] 马琳 孙萌 刘洋 阚艳敏 刘水澎 

机构地区：[1]华北理工大学研究生院,河北省唐山市063000 [2]华北理工大学附属医院超声科 [3]河北省唐山市传染病医院超声科

出　　处：《中国煤炭工业医学杂志》2015年第8期1333-1337,共5页Chinese Journal of Coal Industry Medicine

基　　金：河北省科技支撑计划项目(编号:132777196)

摘　　要：目的初步探讨速度向量成像技术在肝纤维化的诊断及分期中的应用价值。方法选择慢性乙型病毒性肝炎患者(依照病理分期分为S0、S1、S2、S3、S4期五组)共94例,正常对照组30例,常规超声扫查后,连接心电电极,存储肝左叶至少3个心动周期动态图像,启动自带VVI软件测量同一直线上距离膈肌1、2、3cm处肝组织舒张期运动最大速度(Vmax),最大应变(Smax)及最大应变率(SRmax)。结合病理结果对其参数进行分析。结果慢性乙型病毒性肝炎组、对照组肝左叶舒张期Vmax、Smax及SRmax随着距膈肌距离的增加均逐渐减小;S1期与S2期二组之间SRmax比较,差异具有统计学意义(P<0.05);S2、S3、S4期各组之间Vmax、Smax、SRmax比较,差异具有统计学意义(P<0.05),且随着程度加重而减小。通过ROC曲线分析,肝左叶SR3max取值为0.789 s-1时,诊断S2期肝纤维化的灵敏度为86.7%,特异度为77.8%;SR3max取值为0.600s-1时,诊断S3期肝纤维化的灵敏度为88.9%,特异度为76.5%;S1max取值为4.806%时,诊断早期肝硬化(S4期)的灵敏度为94.1%,特异度为73.9%。结论速度向量成像技术在定量诊断肝纤维化中具有独特的优势,有望成为临床上一种无创诊断肝纤维化及早期肝硬化的安全可靠的检测手段。Objective To preliminarily investigate the value of velocity vector imaging（VVI）in the diagnosis and staging of liver fibrosis.Methods Ninty-four patients with chronic hepatitis B virus（HBV）were enrolled,and30 patients with proven healthy livers were used as control group.After all patients with conventional ultrasound scanning,connected ECG electrodes,and store the motion pictures of the left lobe of the liver at least three cardiac cycles.Start VVI software,at diastolic measuring the maximum velocity（Vmax）,the maximum strain（Smax）and the maximum strain rate（SRmax）from the diaphragm1 cm,2cm,3cm in a straight line.The parameters were analyzed combined with fatty liver ultrasound index criteria and pathological results.Results The diastolic Vmax,Smaxand SRmaxof the left hepatic lobe with increasing distance from the diaphragm were decreased in chronic hepatitis B group and the control group;The difference of SRmaxbetween S1 group and S2 group was statistically significant（P〈0.05）;The differences of Vmax,Smaxand SRmaxbetween S2,S3 and S4 groups were statistically significant（P〈0.05）,and were decreased with the aggravation.By ROC curve analysis,SR3 maxvalue of 0.789 s-1,the diagnosis of S2 fibrosis sensitivity and specificity were 86.7%,77.8%;SR3maxvalue of 0.600 s-1,the diagnosis of S3 fibrosis sensitivity and specificity were 88.9%,76.5%;S1maxvalue of 4.806 %,the sensitivity and specificity of diagnosis of severe fatty liver were 94.1% and 73.9%.Conclusions Velocity Vector Imaging technology has a unique advantage in quantitative diagnosis of liver fibrosis,is expected to become a new testing methods to diagnose liver fibrosis and early cirrhosis for clinical.

关 键 词：速度向量成像技术 慢性乙型病毒性肝炎 肝纤维化分期 

分 类 号：R445.1[医药卫生—影像医学与核医学]