二维剪切波弹性成像、瞬时弹性成像、实时组织弹性成像诊断肝纤维化的效能比较  

Comparative study of 2D-SWE, TE and RTE for the evaluation of liver fibrosi

作　　者：郑剑[1] 曾婕[2] 郑荣琴[2] 吴涛[2] 金洁玚 郭欢仪[2] 黄泽萍[2] 曾庆劲[2] 

机构地区：[1]中山大学附属东华医院超声科,东莞523110 [2]中山大学附属第三医院超声科,广州510630

出　　处：《中华医学超声杂志（电子版）》2016年第7期496-500,共5页Chinese Journal of Medical Ultrasound(Electronic Edition)

基　　金：东莞市医疗卫生科技计划一般项目(20131051500154)

摘　　要：目的比较实时二维剪切波弹性成像(2D-SWE)、瞬时弹性成像(TE)、实时组织弹性成像(RTE)评估肝纤维化的诊断效能。方法选取2013年10月至2014年5月在中山大学附属第三医院就诊的慢性肝病患者138例,同时行肝脏2D-SWE、TE及RTE检查,以病理学结果为"金标准",病理肝纤维化分期4组间弹性成像肝硬度检测比较采用方差分析,比较2D-SWE、TE及RTE 3者与肝纤维化分期的Spearman相关系数,相关系数的比较采用Z检验;构建受试者工作特征(ROC)曲线分析诊断效能,计算曲线下面积(AUC),AUC的比较采用De Long法。结果 2D-SWE、TE及RTE与病理肝纤维化分期的相关系数分别为0.707、0.694、0.424,2D-SWE与TE比较差异无统计学意义(Z=0.210,P>0.05),但均优于RTE(Z=3.521、3.312,P值均<0.01)。2D-SWE、TE及RTE诊断显著肝纤维化(S2)与肝硬化(S4)的AUC分别为0.853与0.903、0.861与0.913、0.713与0.719,2D-SWE与TE诊断效能相当(S2:Z=0.296,S4:Z=0.613,P值均>0.05),但均优于RTE(S2:Z=2.003、2.197,S4:Z=1.986、1.983,P值均<0.05)。结论 2D-SWE、TE诊断肝纤维化效能相当,但均优于RTE。Objective To compare two-dimensional shear wave elastography（2D-SWE）, transient elastography（TE） and real-time tissue elastography（RTE） for the assessment of liver fibrosis. Methods One hundred and thirty-eight patients with chronic liver disease were included in Third Affiliated Hospital of Sun Yat-Sen University from October 2013 to May 2014. All patients were assessed by 2D-SWE, TE and RTE in a single day. Pathological fibrosis stage was emloyed as reference standard. The difference between fibrosis stage was compared using one way ANOVA. The correlation coefficient of liver fibrosis and the area under receiver operating characteristic curve（AUC） between the three methods and fibrosis were compared. Results The correlation coefficient between 2D-SWE, TE, RTE and liver fibrosis were 0.707, 0.694, 0.424, respectively, 2D-SWE was equal to TE（Z= 0.210, P〉 0.05）, and superior to RTE（Z=3.521, 3.312, all P〈 0.01）. The comparison of AUC reveals that 2D-SWE were comparable to TE（S2： Z= 0.296, S4： Z= 0.613, all P〉 0.05）, and 2D-SWE and TE were superior to RTE（S2： Z= 2.003, 2.197, S4： Z= 1.986, 1.983, all P 〈0.05）. Conclusion 2D-SWE and TE were comparable in the assessment of liver fibrosis, and were superior to RTE.

关 键 词：肝疾病 肝硬化 弹性成像技术 

分 类 号：R445.1[医药卫生—影像医学与核医学] R575.2[医药卫生—诊断学]