二维剪切波弹性成像与瞬时弹性成像对慢性乙型肝炎患者肝纤维化诊断效能的探讨  

The effect of two-dimensional shear wave elastography and transient elastography in diagnosis of liver fibrosis in patients with chronic hepatitis B

作　　者：崔艾琳 王佳冰[2] 徐莉力 童明辉[2] CUI Ailin;WANG Jiabing;XU Lili;TONG Minghui(Department of Ultrasound,Zhejiang Provincial People’s Hospital,Hangzhou 310014,China)

机构地区：[1]浙江省人民医院超声科,杭州市310014 [2]兰州大学第二医院超声三科

出　　处：《临床超声医学杂志》2018年第12期819-822,共4页Journal of Clinical Ultrasound in Medicine

基　　金：兰州大学第二医院硕导基金项目(SDKYJJ-21)

摘　　要：目的比较二维剪切波弹性成像(2D-SWE)与瞬时弹性成像(TE)对慢性乙型肝炎(CHB)患者肝纤维化分期诊断价值。方法选取我院临床确诊的148例CHB患者,分别行2D-SWE及TE检查,以超声引导下肝组织穿刺活检病理结果为金标准,比较分析两种弹性成像评估肝纤维化分期的诊断效能。结果 2D-SWE及TE所测弹性值与肝纤维化分期均呈显著正相关(r=0.914、0.783,均P<0.05);两种检查方法所测不同肝纤维化分期的弹性值比较差异均有统计学意义(均P<0.05),且均随肝纤维化分期的加重而增加;2D-SWE诊断显著性肝纤维化(S2～S4期)的受试者工作特征(ROC)曲线的曲线下面积分别为0.973、0.976及0.972,均优于TE诊断的曲线下面积(0.903、0.909及0.904),差异均有统计学意义(Z=3.062、3.379、2.539,均P<0.05)。结论 2D-SWE与TE技术在无创诊断CHB患者肝纤维化程度方面具有相似的诊断价值,但2D-SWE技术优于TE,更具有临床应用价值。Objective To compare the diagnostic value between two-dimensional shear wave elastography(2D-SWE)and transient elastography(TE)for the stage liver fibrosis in patients with chronic hepatitis B(CHB).Methods One hundred and forty-eight CHB patients in our hospital were underwent 2D-SWE and TE examinations.The pathological fibrosis stage by ultrasound guided liver biopsy was used as the gold standard to compare the diagnostic efficacy of two kinds of elastography.Results There were positive correlation between the mean elasticity of two kinds of elastography and liver fibrosis stage(r=0.914,0.783,both P<0.05).There were significant differences between the mean elasticity values of 2D-SWE and TE in different pathological fibrosis stage(both P<0.05),and the value of mean elasticity increased with the stage of liver fibrosis.The areas under the ROC curve of 2D-SWE diagnosis of liver fibrosis(S2~S4)were 0.973,0.976 and 0.972,respectively,which were superior to the area under the ROC curve for TE diagnosis(0.903,0.909 and 0.904),and the differences were statistically significant(Z=3.062,3.379,2.539,all P<0.05).Conclusion 2D-SWE and TE technology have similar diagnostic value in noninvasive diagnosis of liver fibrosis with CHB,but the 2D-SWE has higher clinical application value which is superior to TE.

关 键 词：弹性成像 乙型肝炎 慢性 肝纤维化 

分 类 号：R445.1[医药卫生—影像医学与核医学] R512.62[医药卫生—诊断学]