剪切波弹性成像及超声分级对供肝质量评估的价值研究  

Application values of shear wave elastography and ultrasonic grading in liver grafts from brain death donor

作　　者：李绚璇 刘文怡 王建红[1] 赵扬[1] 祝丽娜 王新[1] 郭源[1] 刘泳 Li Xuanxuan;Liu Wenyi;Wang Jianhong;Zhao Yang;Zhu Lina;Wang Xin;Guo Yuan;Liu Yong(Liver Disease Center, Affiliated Hospital of Qingdao University, Qingdao 266100, China, is working at Qingdao Hiser Medical Center;Qingdao Hiser Medical Center, Qingdao 266033, China)

机构地区：[1]青岛大学附属医院肝脏病中心,266100 [2]青岛市海慈医疗集团,266033

出　　处：《中华器官移植杂志》2019年第4期211-214,共4页Chinese Journal of Organ Transplantation

基　　金：青岛市民生科技计划项目(17-3-3-13-nsh).

摘　　要：目的探讨剪切波弹性成像及超声分级在脑死亡器官捐献供肝质量评估中的应用价值。方法回顾性分析我院2017年3月至2018年5月脑死亡器官捐献供肝39例的影像学资料,肝移植术前对供肝行剪切波弹性成像(shear wave elastography.SWE)及二维超声分级及肝功能等实验室检査,根据肝移植受者术后早期肝功能恢复情况对应供肝分为早期肝功能恢复延迟(early allograftdysfunction,EAD)组和早期肝功能恢复正常组,比较两组间SWE值及二维超声分级的差异有无统计学意义,利用工作特征曲线(receiver operating curve,ROC)分析SWE及超声分级诊断EAD的价值。结果EAD组SWE值及超声分级均较早期肝功能恢复正常组高,差异有统计学意义(EAD组SWE值(6. 65 ± 2. 69) kPa,非 EAD组(3. 50± 1. 27) kPa;EAD组超声分级 4 级占 73. 3%,非 EAD组 3 级占70. 6%,P值均<0. 05)。将供肝SWE值及超声分级进行ROC分析,供肝SWE诊断EAD的ROC曲线下面积为0. 939(P<0. 001),最佳阈值为4. 56 kPa(敏感度90. 0%,特异度7& 9%),超声分级的ROC曲线下面积为0. 806(P = 0.003),最佳阈值为3. 5级(敏感度86.7%,特异度70.6%)。结论剪切波弹性成像技术可以量化供肝硬度值,剪切波弹性成像技术及超声分级与肝移植受者术后EAD发生有一定关联,剪切波弹性成像技术及超声分级对脑死亡器官捐献供肝质量的评估有应用价值。Objective To explore the values of shear wave elastography (SWE) and ultrasonic grading in liver grafts from brain death donor (DBD). Methods Liver grafts of 39 DBD cases were examined preoperatively by ultrasonography ( US) and SWE. Blood samples were tested preoperatively. Based upon early allograft function of liver recipients, the donors were classified into early allograft dysfunction (EAD) and early allograft function normal (non-EAD) groups. The SWE/ US grading results of EAD group were compared with those of non-EAD group. Receiver operating curve (ROC) was employed for analyzing the diagnostic accuracy of SWE/US grading in EAD. Results The SWE value of EAD group was significantly higher than that of non-EAD group [(6. 65 ± 2. 69) vs.(3. 50 ± 1. 27) kPa, P<0. 05]. Ultrasonic grading of EAD group was also significantly higher than that of non-EAD group (P<0. 05). The area under ROC curve (AUROC) of SWE in EAD was 0. 939, optimal cut-off value 4. 56 kPa, AUROC of ultrasonic grading 0. 806 (P = 0. 003) and optimal cut-off value level 3. 5. Conclusions SWE quantifies fibrosis in liver grafts of DBD w让h a high diagnostic accuracy. There are significant correlations between EAD after liver transplantation and SWE value of liver grafts and ultrasonic grading. SWE and ultrasonic grading may improve the assessments of liver grafts of DBD.

关 键 词：肝移植 超声成像 功能恢复 

分 类 号：R445.1[医药卫生—影像医学与核医学] R657.3[医药卫生—诊断学]