二维剪切波弹性成像诊断乙肝肝硬化患者高危食管静脉曲张的初步研究  

The Value of Two Dimensional Shear Wave Elastography in the Diagnosis of High Risk Esophageal Varices in Patients with Hepatitis B Cirrhosis

作　　者：杨学平[1] 张瑶[1] 王雪梅 王玥[1] 于静 张记[1] 潘国栋 Yang Xueping;Zhang Yao;Wang Xuemei;Wang Yue;Yu Jing;Zhang Ji;Pan Guodong(Department of Ultrasound,Beijing Ditan Hospital,Capital Medical University,Beijing 100015,China)

机构地区：[1]首都医科大学附属北京地坛医院超声科,北京市100015

出　　处：《中国超声医学杂志》2020年第6期532-535,共4页Chinese Journal of Ultrasound in Medicine

基　　金：首都医科大学附属北京地坛医院院内科研基金(No.DTYM201816)。

摘　　要：目的初步探索二维剪切波弹性成像(2D-SWE)测量乙肝肝硬化患者肝硬度值(LSM)、脾硬度值(SSM)诊断高危食管静脉曲张(HREV)的可行性。方法收集172例乙肝肝硬化患者的临床资料,根据内镜分为HREV组及低危食管静脉曲张(LREV)组,2D-SWE测量LSM、SSM,应用ROC曲线评估LSM、SSM诊断HREV的效能,计算曲线下面积(AUC)、灵敏度(Se)、特异度(Sp)、阳性预测值(PPV)及阴性预测值(NPV)。结果HREV组患者84例,LREV组88例,LSM诊断HREV的AUC为0.575(P=0.084);SSM诊断HREV的AUC为0.941(P<0.001),取最优截断值43.5 kPa时,Se、Sp、PPV及NPV分别为84.5%、90.9%、89.9%、86.0%。结论2D-SWE是一种可靠、易操作、无创性的技术,可用于测量SSM筛查乙肝肝硬化患者HREV。Objective To explore the value of LSM and SSM by 2 D-SWE for diagnosising HREV in patients with hepatitis B cirrhosis.Methods The clinical data of 172 patients with hepatitis B cirrhosis from March were collected.According to endoscopy,the patients were divided into HREV and LREV group.LSM and SSM was detected by 2 D-SWE.Evaluating the value of LSM and SSM for diagnosing HREV by ROC curve.The area under curve(AUC),sensitivity(Se),specificity(Sp),positive predictive value(PPV)and negative predictive value(NPV)were calculated.Results There were 84 patients with HREV and 88 patients with LREV.SSM≥43.5 kPa with an AUC of 0.941(P<0.001),had a Se of 84.5%,Sp of 90.9%,PPV of 89.9%,NPV of 86.0%for Diagnosising HREV.The AUC of LSM was 0.575(P=0.084).Conclusions 2 D-SWE is a reliable,easy to operate and non-invasive method,which can be used to measure SSM to screen HREV in patients with hepatitis B cirrhosis.

关 键 词：食管静脉曲张 二维剪切波弹性成像 乙肝肝硬化 

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]