肝泡球蚴病灶边缘移行带ARFI检查与纤维化程度的相关性研究  

The Correlation Between ARFI Inspection in Border of Hepatic Alveolar Echinococcosis Edge Transition Zone and The Degree of Liver Fibrosis

作　　者：华国勇[1] 张玉英[1] 郭建琴[1] 杨蓉[1] 王有清 Hua Guoyong Zhang Yuying Guo Jianqin Yang Rong Wang Youqing(Qinghai Provincial People＇s Hospital（ 810007 Fifth People＇s Hospital of Qinghai Province（810007)

机构地区：[1]青海省人民医院,810007 [2]青海省第五人民医院,810007

出　　处：《高原医学杂志》2016年第2期1-5,共5页Journal of High Altitude Medicine

基　　金：青海省卫计委立项项目

摘　　要：目的:利用声脉冲辐射力弹性成像技术评价和分析肝泡球蚴病病灶边缘移行带平均剪切波速度值与其纤维化程度的相关性,探讨平均剪切波速度值在病灶增殖活性的应用价值。方法:41例肝泡球蚴病患者均行肝脏声脉冲辐射力弹性成像技术检查,获得二维超声及弹性图像,对应病理取材部位测得病灶实质、边缘区域及周围肝脏组织平均剪切波速度值,并进行比较;取其中35例患者的术后或穿刺活检组织标本,对病灶边缘区域取材,行Masso N染色和HE染色,分析边缘移行带平均剪切波速度值与镜下纤维化程度的相关性。结果:41例患者的病灶实质、病灶边缘区域和周围肝脏组织的平均剪切波速度值比较差异有统计学意义(P<0.05);35例患者术后组织标本显示病灶边缘区域的平均剪切波速度值随纤维化程度增加而波速增高,有明显相关性。结论:肝泡球蚴病灶边缘存在较周围肝实质高、较病灶内部低平均剪切波速度值的移行带;移行带平均剪切波速度值在一定程度上反映了病灶新近的纤维化程度变化,可用于评价病灶浸润增殖活性;移行带的平均剪切波速度值与镜下纤维化程度明显正相关;具有早期、准确、可定量的优势;声脉冲辐射力弹性成像技术有望用于评价肝泡球蚴病灶的浸润增殖活性及术后评估,有助于肝泡球蚴病自体肝移植的术前及术后评估。Objective：To analysis the correlation between Acoustic radiation force impulse elastography （ARFI） and the fibrosis degree in the border of hepatic alveolar echinococcosis （HAE） and to investigate the clinical value of SWV values in evaluating the proliferation of HAE. Methods ：41 cases with HAE were underwent ARFI examination . The SWV values of the center, the border and the around liver tissue of lesion were measured with liver ARFI analysis software. Of the 41 cases with HAE, 35 cases underwent operations. The slides of sample were stained with MASSON, to mark fibrosis . The correlation between SWV values parameters and fibrosis area were analyzed. Results：There was statistically significant difference among the groups of the center, border and the around liver tissue of SWV values of 41 case （ P 〈 0. 05 ）. There was significant correlation between the SWV values and 35 case with postoperative tissue scale display SWV value of the edge region of the lesion with fibrosis, the degree of increased velocity was positively correlated. Conclusion： There is transitional zone exists at the edge of the HAE lesions with echogenicity , it is lower than the interhal of lesions but higher than the surrounding liver parenchyma. To some extent fringe SWV value reflects the recent change in lesion fibrosis, it can be used to evaluate the prolifer- ative activity of tumor infiltration. SWV value is correlated with the microscopic fibrosis of transitional zone. Having an early, accurate and quantitative advantages. ARFI expected for the proliferation and infiltration postoperative evaluation HAE lesions, helps liver alveolar hydatid disease preoperative and postoperative evaluation of autologous liver transplantation.

关 键 词：肝泡状棘球蚴 边缘带 声脉冲辐射力弹性成像技术 纤维化 平均剪切波速度 

分 类 号：R532.32[医药卫生—内科学]