实时超声弹性成像组织弥散定量分析技术对肝外梗阻性黄疸的定量化研究  

Quantitative research on patients with extrahepatic obstructive jaundice using real-time ultrasound elasticity tissue dispersion quantitative analysis technique

作　　者：吴宇 余小情[2] 祝桂新 郭苏华 杜凤云 

机构地区：[1]上海沪东医院超声科,上海市200129 [2]上海交通大学附属瑞金医院卢湾分院超声科

出　　处：《临床超声医学杂志》2017年第6期399-403,共5页Journal of Clinical Ultrasound in Medicine

摘　　要：目的探讨实时超声弹性成像组织弥散定量分析技术对肝外梗阻性黄疸的诊断。方法选取我院肝外梗阻性黄疸患者90例(黄疸组),依据血总胆红素水平将其分为重、中及轻度黄疸组,各30例;同时选取同期无临床黄疸的健康体检者30例为无黄疸组。分别测量并比较各组AREA%、MEAN存在的差异。应用受试者工作特征(ROC)曲线分析AREA%、MEAN鉴别有无黄疸,以及发生轻度黄疸与中重度黄疸的ROC曲线下面积(AUC)、截断值、敏感性及特异性;应用Pearson相关性分析,评估AREA%、MEAN与总胆红素水平的关系。结果轻度黄疸组AREA%高于无黄疸组,中、重度黄疸组AREA%指标高于轻度黄疸组,差异均有统计学意义(均P<0.05)。ROC曲线分析显示,AREA%诊断黄疸的截断值、敏感性、特异性分别为44.44%、58.9%、83.7%;AREA%诊断轻度黄疸的截断值、敏感性、特异性分别为43.54%、65.0%、86.7%;AREA%诊断中重度黄疸的截断值、敏感性、特异性分别为47.21%、68.0%、92.5%。轻度黄疸组MEAN低于无黄疸组,中、重度黄疸组MEAN低于轻度黄疸组,差异均有统计学意义(均P<0.05)。ROC曲线分析显示,MEAN诊断黄疸的截断值、敏感性、特异性分别为81.04、83.3%、78.9%;MEAN诊断轻度黄疸的截断值、敏感性、特异性分别为83.07、53.3%、90.0%;MEAN诊断中重度黄疸的截断值、敏感性、特异性分别为79.95、65.0%、98.0%。结论通过两种弹性定量参数能够初步诊断肝外梗阻性黄疸,并评估患者梗阻程度。Objective To investigate the value of real-time ultrasound elasticity tissue dispersion quantitative analysis technique in the diagnosis of obstructive jaundice（OJ）. Methods Ninety patients with OJ were enrolled. According to total bilirubin,they were divided into severe OJ group,moderate OJ group and slight OJ group, each group has 30 cases. In the same time,30 cases without clinical jaundice were also selected. The AREA% and MEAN among the groups were compared and analyzed. ROC curves were drawn to evaluate the AUC,cut-off point,sensitivity and specificity of slight,moderate and severe OJ. The correlation between AREA%,MEAN levels and total bilirubin was assessed with Pearson correlation analysis. Results AREA%in slight OJ group was higher than that in normal group,and AREA%in moderate and severe OJ group was higher than that in slight OJ group（all P〈0.05）. ROC curve showed that the cut-off point,sensitivity and specificity in diagnosing OJ for AREA%were 44.44%,58.9%and 83.7%,respectively. The cut-off point,sensitivity and specificity in diagnosing slight OJ were 43.54%, 65.0%and 86.7%,respectively. The cut-off point,sensitivity and specificity in diagnosing medium and serious OJ were 47.21%, 68.0% and 92.5%,respectively. Furthermore,MEAN in slight OJ group was lower than that in normal group,and MEAN in moderate and severe OJ group was lower than that in slight OJ group（all P〈0 .05）. ROC curve showed that the cut-off point, sensitivity and specificity in diagnosing OJ for MEAN were 81 . 04 , 83 .3% and 78.9%,respectively.The cut-off point, sensitivity and specificity in diagnosing slight OJ were 83.70,53.3% and 90.0%,respectively.The cut-off point,sensitivity and specificity in diagnosing medium and serious OJ were 79.95%,65.0% and 98.0%,respectively. Conclusion Quantitative ultrasound elastic parameters can effectively identify OJ and degree of obstruction.

关 键 词：超声弹性成像 弹性定量参数 梗阻性黄疸 

分 类 号：R442.4[医药卫生—诊断学] R445.1[医药卫生—临床医学]