声学结构定量技术评价乙肝肝纤维化分期的价值  

Ultrasound Evaluation of Pathological Stages of Hepatic Fibrosis in HBV with Acoustic Structure Quantification(ASQ)

作　　者：郭欢仪[1] 杨丽新[1] 曾婕[1] 郑剑[1] 吴涛[1] 黄泽萍[1] 郑荣琴[1] 

机构地区：[1]中山大学附属第三医院超声科,广东广州510630

出　　处：《中山大学学报（医学科学版）》2016年第1期137-141,共5页Journal of Sun Yat-Sen University:Medical Sciences

摘　　要：【目的】评价声学结构定量技术在肝纤维化分期的应用价值。【方法】2013年5月至2014年4月我院慢性乙型肝炎患者122例,同时行声学结构定量技术分析及肝活检病理分期。比较肝纤维化病理分期与ASQ各定量参数:Total Mode(总众数),Total Average(总均值),Red Mode(红色曲线众数),Red Average(红色曲线均值),Red SD(红色曲线标准差),Blue Mode(蓝色曲线众数),Blue Average(蓝色曲线均值),Blue SD(蓝色曲线标准差),及BR ratio(蓝红直方图曲线下面积比值),分析其相关性。同时,以相关性较高的参数诊断肝纤维化分期构建受试者工作特征曲线(ROC),分析其在肝纤维化各分期的诊断效能。【结果】ASQ的各定量参数中,除Blue Average外,其他各参数与纤维化分期的相关性均具有统计学意义。其中Total Mode和BR ratio与病理纤维化S分期的相关系数较高。Total Mode和BR ratio诊断肝纤维化各分期的ROC曲线下面积比较,仅S≥2有统计学差异,其余均没有统计学差异。Total Mode在S≥2和S=4的肝纤维化分期诊断中ROC曲线下面积为0.751和0.703,其余ROC曲线下面积均低于0.700。【结论】超声组织结构声学定量技术(ASQ)能无创、定量行肝纤维化分期诊断,其中以Total Mode和BR ratio与病理分期的相关性较高,在ROC曲线下面积的分析比较中,以Total Mode在S≥2和S=4肝纤维化分期中诊断价值达中等。【Objective】 To explore the value of acoustic structure quantification（ASQ） in grading hepatic fibrosis. 【Methods】122 cases with chronic hepatitis B virus infection were enrolled in our study from May 2013 to April 2014. Both ASQ and liver biopsy were performed on these patients. Analyzing the correlation between the pathological stages of hepatic fibrosis and ASQ parameters,including： Total Mode, Total Average, Red Mode, Red Average, Red SD, Blue Mode, Blue Average, Blue SD and BR ratio. The well-correlation of ASQ parameters with the staging of hepatic fibrosis were analyzed with receiver operating characteristic（ROC）curve, by calculating the difference between the areas under the ROC curve（AUROC）. 【Results】 Excepting the Blue Average, the other parameters showed significant correlation with pathological stages of fibrosis, as Total Mode and BR ratio showed a higher correlation. Except that S≥2 subgroup had a significant difference, the other subgroup showed no differences, between the areas under the ROC curve set up by evaluating the pathological stages of fibrosis through Total Mode 和 BR ratio. AUROC for the diagnosis of fibrosis S≥2 and S = 4 were 0.751 and 0.703 for total mode respectively, while the other AUROC for the diagnosis of fibrosis were lower than 0.700. 【Conclusion】 Acoustic Structure Quantification（ASQ） is a noninvasive and quantitative tool in the evaluation of hepatic fibrosis. Total Mode and BR ratio showed a higher correlation with degreed of fibrosis, among other ASQ parameters. AUROC for the diagnosis of fibrosis S ≥ 2 and S = 4 showed a mild diagnosis value for Total Mode.

关 键 词：超声检查 声学结构定量技术 乙肝 纤维化 

分 类 号：R445.1[医药卫生—影像医学与核医学]