实时剪切弹性波成像对不同原因兔脂肪肝肝脏硬度的评价  

Analysis on the evaluation of the real-time shear wave elastography imaging to the fatty liver of rabbit liver stiffness for different reasons

作　　者：汤跃跃[1] 周虹[2] 张勇[1] 李云燕[1] 徐丽荣 陆永萍[1] TANG Yueyue;ZHOU Hong;ZHANG Yong;LI Yunyan;XU Lirong;LU Yongping(Department of Medical Ultrasound,the Second Peoples Hospital of Yunnan Province,Kunming 650021,China)

机构地区：[1]云南省第二人民医院超声科,昆明650021 [2]云南省第二人民医院病理科,昆明650021

出　　处：《实用医学杂志》2018年第11期1757-1761,共5页The Journal of Practical Medicine

基　　金：云南省医学领军人才培养基金项目(编号:L-201616);云南省自然科学基金面上项目(编号:2012FB081)

摘　　要：目的采用实时剪切弹性波成像检测高脂及酒精喂养的兔肝脏的弹性(硬度),并与病理对照,探讨不同原因导致的脂肪肝形成过程中肝脏硬度的发展趋势。方法 60只雄性日本大耳白兔,随机平均分为正常组、单纯性脂肪肝组及酒精性脂肪组。分别于不同时期行常规超声及弹性成像观察。测量兔肝脏弹性模量值(最大值、平均值及最小值)。20周后处死动物,将病理结果与弹性模量值进行比较,得出诊断肝纤维化分期的弹性模量值参考范围。结果单纯性脂肪肝组及酒精性脂肪肝组弹性模量值平均值均高于正常组(P<0.01);且酒精性脂肪肝组弹性模量平均值高于单纯性脂肪肝组(P<0.01)。酒精性脂肪肝组与单纯性脂肪肝组弹性模量平均值随病程增加(P<0.01)。S1~S4期弹性模量平均值诊断界值分别为:7.15、12.05、13.80、18.15 kPa。ROC曲线显示诊断肝硬化各期(S1、S2、S3、S4)的曲线面积分别为:0.957、1.000、0.991、0.997。结论实时剪切波弹性成像作为一种无创性的手段,能较客观反映肝脏硬度,检测不同病因引起的脂肪肝形成过程中纤维化发展的进程。Objective Using real-time shear wave elastography to detect the liver elasticity（hardness）ofpure high-fat and alcohol feeding rabbit,compared with pathology and explore the liver stiffness in the process ofdevelopment trend due to different causes. Methods 60 male Japanese big ear rabbit were randomly divided intonormal group,simple fatty liver group and alcoholic fat group. Conventional ultrasonography and elastic imagingwere observed at various periods. Measure the elastic modulus value（maximum,mean and minimum）. The animalwas executed after 20 weeks,and the pathological results were compared with the elastic modulus. The elastic mod-ulus of the liver fibrosis stage was obtained. Results The mean value of elastic modulus value of average simplefatty liver group and alcoholic fatty liver group were higher than normal group（P〈0.01）. The mean value of elas-tic modulus of alcoholic fatty liver group was higher than simple fatty liver group（P〈0.01）. The mean value ofelastic modulus of alcoholic fatty liver group and simple fatty liver group were increased with the course of disease（P〈0.01）. The diagnostic boundary values of S1 - S4 period were：7.15,12.05,13.80,18.15 k Pa. The ROCcurve showed that the curve area is 0.957,1.000,0.991 and 0.997,respectively. Conclusions As a noninvasivemethod,real-time shear wave elastography can objectively reflect the hardness of the liver,and detect the processof fibrosis development in the process of fatty liver formation caused by different etiologies.

关 键 词：脂肪肝 实时剪切弹性波成像 肝脏硬度 

分 类 号：R445.1[医药卫生—影像医学与核医学] R575.5[医药卫生—诊断学]