声速匹配组织量化技术对慢性乙型肝炎肝纤维化分期的初步探讨  

Preliminary research of sound velocity tissue quantification on liver fibrosis stage

作　　者：王倩[1] 艾红[1] 张茜茜[1] 魏炜[1] 白韵菲 

机构地区：[1]西安交通大学第一附属医院超声科,710061

出　　处：《中华超声影像学杂志》2016年第1期29-35,共7页Chinese Journal of Ultrasonography

摘　　要：目的探讨声速匹配组织量化（soundvelocitytissuequantification，SVQ）技术对慢性乙型病毒性肝炎肝纤维化分期的定量研究及其与血清学指标对肝纤维化分期的对比性研究。方法选取经临床及病理确诊的慢性乙型肝炎患者99例作为病例组，同期健康体检者30例作为对照组。对病例组与对照组分别应用SVQ技术检测肝实质的声速匹配指数（zonespeedindex，ZSI），并计算天冬氨酸转氨酶与血小板比值指数（AST／PLTratioindex，APRI）。以肝穿刺活检病理学检查为金标准，分析比较ZSI和APRI指数对慢性乙型肝炎肝纤维化的诊断价值。结果①慢性乙型肝炎患者肝纤维化分期为SO～s4期的ZSI分别为（15．9±5．7）m／s、（28．1±2．8）m／s、（35．8±1．2）m／S、（42．6±0．8）m／s、（46．3±1．3）m／s。②ZSI及APRI在不同肝纤维化分期的ROC曲线的分析结果：ZSI和APRI诊断慢性乙型肝炎肝纤维化S≥S1的ROC曲线下面积分别为0．875、0．762，S≥S2的ROC曲线下面积分别为0．832、0．597，S≥S3的ROC曲线下面积分别为0．913、0．675，S=S4的ROC曲线下面积分别为0．891、0．709。结论SVQ技术所得ZSI对慢性乙型肝炎肝纤维化的诊断价值略优于APRI，可对肝纤维化程度进行初步判定并提供量化信息。Objective To evaluate sound velocity tissue quantification （SVQ） for the quantitative assessment of liver fibrosis stage in chronic hepatitis B, and to evaluate the correlation between diagnostic performance of sound velocity tissue quantification and blood parameters. Methods From the May of 2013 to May of 2014, collect ninety-nine patients with chronic hepatitis B who was diagnosed by clinic and / or liver biopsy as experiment group, and thirty healthy volunteers as control group at the same time. The experiment group and control group were evaluated with to measurement the zone speed index（ZSI）, and blood cell count. The AST/PLT ratio index（APRI） was calculated according the following formula, APRI = AST（ULN）/PLT（109/L）. The liver biopsy was performed in the same day with SVQ and all blood parameters. ZSI and APRI were compared by correlation with liver fibrosis stage in chronic hepatitis B. Referring to the histologic fibrosis stage on liver biopsy, all the ZSI and the APRI value were assessed by using ROC curve analysis. The corresponding cut-off value, sensitivity and specificity were also calculated and compared. Results 1）The mean values of APRI were （15.9 ± 5.7）m/s for patients with SO, （28.1 ±2.8）m/s for patients with S1, （35.8 ± 1.2）m/s for patients with S2, （42.6 ± 0.8）m/s for patients with S3, and （46.3± 1.3）m/s for patients with S4. 2）Accordingly, the areas under the ROC curve for ZSI and APRI were 0.875 and 0.762 for S≥S1,0.832 and 0.597 for S≥S2,0.913 and 0.675 for S≥S3,0.891 and 0.709 for S≥S4, respectively. Conclusions The ZSI and APRI all could be used to evaluate the stage of liver fibrosis, but the ZSI index is superior to APRI in assessing the stage of liver fibrosis. SVQ could provide object and accurate image, the quantitative analysis of tissue could timely and accurately evaluate the severity of liver fibrosis.

关 键 词：超声检查 乙型肝炎 肝硬化 声速匹配组织量化技术 

分 类 号：R512.62[医药卫生—内科学]