声脉冲辐射力成像联合肝固有动脉血流动力学评估肝硬化程度  

Diagnostic value of acoustic radiation force imaging combined with hepatic artery hemodynamics in evaluating the degree of liver cirrhosis

作　　者：丰乃奇[1,2] 曲俊朴[2] 王雪瑞[2] 徐霞[2] 董云[3] 

机构地区：[1]鄂尔多斯市东胜区人民医院超声科,内蒙古017000 [2]内蒙古医科大学临床医学院鄂尔多斯市中心医院超声科,内蒙古017000 [3]上海市东方医院超声科,上海200120

出　　处：《放射学实践》2016年第9期886-889,共4页Radiologic Practice

基　　金：国家自然科学基金(61471231)

摘　　要：目的:探讨声脉冲辐射力成像(ARFI)联合肝固有动脉血流动力学评估肝硬化程度的价值。方法:选取135例肝硬化患者为观察组,按照Child-Pugh(CP)评分对患者肝硬化程度进行分级;选取50例健康志愿者作为对照组。检测所有研究对象(观察组和对照组)的肝固有动脉血流动力学指标,包括收缩期峰值流速(PSV)和阻力指数(RI),并进行ARFI检查,测量肝实质硬度值(LS)。分析不同CP评分分级的LS值、PSV及RI,采用受试者工作特征(ROC)曲线分析LS值与PSV、RI单用或联合应用对肝硬化的诊断价值。结果:观察组CP评分A、B、C三级患者的LS值、PSV及RI值均明显高于对照组,且C级>B级>A级,差异均具有统计学意义(P<0.05)。CP评分与LS值、PSV及RI均呈显著正相关(r=0.727、0.683、0.608,P值均<0.05)。LS值与PSV、RI联用的ROC曲线下面积高于单个指标。结论:ARFI检测的LS值联合肝固有动脉血流动力学指标对评估肝硬化程度具有重要价值。Objective：To explore the diagnostic value of acoustic radiation force imaging （ARFI） combined with hepatic artery hemodynamics in evaluating the degree of liver cirrhosis. Methods：One hundred and thirty-five patients with liver cirrhosis were involved as the observation group, and the degree of liver cirrhosis were graded by Child Pugh （CP） score. A total of 50 healthy volunteers were enrolled as the control group. Hepatic artery hemodynamics indexes peak systolic velocity （PSV） and resistance index （RI） of all subjects were detected. Then the liver parenchyma hardness value （LS） was measured by ARFI technique. LS, PSV and RI were observed in subjects with different CP grade, and the diagnostic value of parameters used alone or combined was analyzed by receiver operating characteristic （ROC） curve. Results： LS,PSV and RI with A,B,C three levels of CP score in the observation group were higher than the control group （class C〉class B〉class A）. The differences were statistically significant （P^0.05）. CP score was significantly positively correlated with LS,PSV and RI （r=0. 727 ,r=0. 683 ,r=0. 608 ,respectively,all P〈0.05）. The AUC of LS values in different CP grades were higher than PSV and RI. The AUC of combination of LS value,PSV and RI was higher than single parameter used alone. Conclusion：The diagnostic value of ARFI combined with hepatic artery hemodynamics in evaluating the degree of liver cirrhosis is more satisfied.

关 键 词：肝硬化 声辐射力脉冲成像 肝固有动脉 血流动力学 

分 类 号：R575.2[医药卫生—消化系统] R445.1[医药卫生—内科学]