超声检测肝区域速度指数和肝脏实质回声在乙肝肝纤维化诊断中的应用  

Application of zone speed index of ultrasonic detection in liver and liver parenchymal echo intensity in the diagnosis of hepatic fibrosis

作　　者：宋征蓉 陈小维[1] 李家琼[1] 黄昊飞[1] SONG Zheng-rong;CHEN Xiao-wei;LI Jia-qiong;HUANG Hao-fei(Pengzhou Traditional Chinese Medicine Hospital of Sichuan Province,Pengzhou 611930,China)

机构地区：[1]四川省彭州市中医医院,四川彭州611930

出　　处：《实用医院临床杂志》2020年第4期102-106,共5页Practical Journal of Clinical Medicine

基　　金：四川省中医药管理局科研项目(编号:2018ZC009)。

摘　　要：目的探讨超声检测肝区域速度指数(zone speed index,ZSI)和肝脏实质回声在乙肝肝纤维化诊断中的应用价值。方法选择2017年4月至2019年4月疑似乙肝肝纤维化患者150例作为研究组,选择同期健康者50名作为对照组。所有患者先进行常规超声检测肝脏实质回声强度,然后通过彩色多普勒超声仪检测ZSI值。检测当天在超声引导下进行穿刺病理学活检。比较不同肝纤维化分期的回声强度和ZSI值的特点。使用受试者工作特征(receiver operating characteristic,ROC)曲线分析肝实质回声和ZSI对肝纤维化的诊断价值。结果研究组中S0、S1、S2、S3、S4分别为34例、50例、25例、21例和20例。Spearman相关性分析结果显示回声强度评分和ZSI分别与肝纤维化分期呈正相关关系(P<0.05)。S0和S1、S1和S2以及S3和S4的回声强度评分比较差异无统计学意义(P>0.05),其他不同分期的回声强度评分比较差异显著(P<0.05)。不同肝纤维化分期的ZSI值比较差异有统计学意义(P<0.05)。ZSI对肝纤维化分期≥S1、≥S2、≥S3、≥S4的诊断临界值分别为20.451、22.282、23.540与26.021 m/s,ROC曲线下面积分别为0.9584、0.9515、0.9637和0.9506。ZSI对各个分期的肝纤维化诊断的灵敏度和特异度高于回声强度。结论相比于肝实质回声强度,ZSI对各个分期的乙肝肝纤维化的诊断效果、敏感度和特异度均较好。Objective To explore the value of zone speed index(ZSI)of ultrasonic detection in liver and liver parenchymal echo intensity in the diagnosis of liver fibrosis.Methods One hundred and fifty patients with suspected hepatitis B liver fibrosis from April 2017 to April 2019 were selected as study groups.Fifty healthy people in the same period were selected as control group.All the patients were subjected to conventional ultrasound examination to detect the parenchymal echo intensity of the liver,and then the ZSI value was detected by color Doppler ultrasound system.On the day of the test,a puncture pathology biopsy was performed under ultrasound guidance.The characteristics of echo intensity and ZSI value for different stages of liver fibrosis were compared.The receiver operating characteristic(ROC)curve analysis was used to analyze the diagnostic value of hepatic parenchymal echo intensity and ZSI for liver fibrosis.Results In the study group,S0,S1,S2,S3,and S4 were 34,50,25,21 and 20 cases,respectively.Spearman correlation analysis showed that the echo intensity score and ZSI were positively correlated with liver fibrosis stage(P<0.05).There was no significant difference in the echo intensity scores between S0 and S1,S1 and S2,and S3 and S4(P>0.05).However,the echo intensity scores of other different stages were significantly different(P<0.05).The ZSI of different liver fibrosis stages was significantly different(P<0.05).The diagnostic thresholds of ZSI at S1,S2,S3 and S4 liver fibrosis stages were 20.451,22.282,23.540 and 26.021 m/s,respectively,and the area under the ROC curve were 0.9584,0.9515,0.9637 and 0.9506,respectively.The sensitivity and specificity of ZSI for the diagnosis of liver fibrosis in each stage was higher than those of echo intensity.Conclusion Compared with the echo intensity of liver parenchyma,ZSI has a good diagnostic effect,sensitivity and specificity for each stage of chronic hepatitis B liver fibrosis.

关 键 词：慢性乙型肝炎 肝纤维化 超声检测声速匹配组织量化 肝区域速度指数 

分 类 号：R445.1[医药卫生—影像医学与核医学] R575.2[医药卫生—诊断学]