二维剪切波弹性成像定量评估慢性乙肝患者早期肝纤维化程度的临床应用  

Clinical Value of Two Dimensional Shear-Wave Elastography (2D-SWE) to Quantitatively Evaluate Early Hepatic Fibrosis of Patients with Chronic Hepatitis B

作　　者：黄建新 戴琳[2] 张妍琰[2] 李璇[2] 刘浩[2] 刘志 Huang Jianxin(Department of Ultrasound,The Affiliated Hospital of Putian University,Putian,Fujian)

机构地区：[1]福建省莆田学院附属医院超声科 [2]广东省南方医科大学南方医院超声科

出　　处：《黑龙江医药》2019年第3期535-539,共5页Heilongjiang Medicine journal

基　　金：南方医科大学附属南方医院“医疗新技术基金”支持(基金号:2016024)

摘　　要：目的:探讨二维剪切波弹性成像(2D-SWE)技术评估慢性乙肝患者早期肝纤维化的临床价值。方法:本研究纳入了32例慢性乙肝患者且二维超声可疑早期纤维化者,对其分别进行二维超声半定量评分、2D-SWE检查,以及血清学指标,并与病理肝纤维化程度进行对比。结果:本组资料的病理结果提示肝纤维化程度S1期3例,S2期18例,S3期11例。2D-SWE的弹性模量值在S1(5.7±1.4kPa)、S2(9.0±2.7kPa)、S3(18.6±7.3kPa)期之间均有明显差异(P<0.01)。2D-SWE的弹性模量值和其肝纤维化病理分期(r=0.552,P<0.01)、二维超声半定量评分(r=0.371,P<0.05)及血清指标(P<0.05)均呈正相关关系。结论:2D-SWE可以准确、无创地评估慢性乙肝患者的早期肝纤维化程度。Objective: To investigate the clinical value of two dimensional shear-wave elastography (2D-SWE) to evaluate early hepatic fibrosis of patients with chronic hepatitis B. Methods: This study recruited 32 patients with chronic hepatitis B and suspicious early hepatic fibrosis detected by two dimensional sonography. A semi-quantitative evaluation by two dimensional sonography, 2D-SWE examination, and serum markers were detected for those patients. Results above were compared with hepatic fibrosis results confirmed by histopathology. Results: Histopathological results indicated 3 cases of S1 stage of hepatic fibrosis, 18 cases of S2 stage and 11 cases of S3 stage. There were significant differences among the elastic modulus of S1 (5.7 ± 1.4 kPa), S2 (9.0 ± 2.7 kPa), and S3 (18.6± 7.3 kPa) stages of hepatic fibrosis ( P <0.01). The elastic modulus of 2D-SWE were positively correlated with hepatic fibrosis determined by histopathology ( r =0.552, P <0.01), semi-quantitative evaluation by two dimensional sonography ( r = 0.371 , P <0.05), and serum markers ( P <0.05). Conclusion: 2D-SWE could provide a accurate and non-invasive evaluation of early hepatic fibrosis for patients with chronic hepatitis B.

关 键 词：弹性成像 剪切波 慢性乙肝 肝纤维化 

分 类 号：R575.1[医药卫生—消化系统]