组织结构声学定量技术诊断慢乙肝性肝硬化和非酒精性脂肪肝的临床价值  

Clinical value of ASQ in the diagnosis of chronic hepatitis b cirrhosis and non-alcoholic fatty liver disease

作　　者：李晓金[1] 郑慧[1] Li Xiaojin;Zheng Hui(Dept of Medical Ultrasonics,The First Affiliated Hospital of Anhui Medical University,Hefei 230022)

机构地区：[1]安徽医科大学第一附属医院超声科,合肥230022

出　　处：《安徽医科大学学报》2020年第12期1931-1935,共5页Acta Universitatis Medicinalis Anhui

基　　金：安徽省公益性研究联动计划项目(编号:1604f0804027)。

摘　　要：目的探究组织结构声学定量(ASQ)技术在慢性乙型肝炎性肝硬化(CHBC)和非酒精性脂肪肝(NAFLD)诊断中的临床价值。方法收集30例健康志愿者、40例慢性乙型肝炎性肝硬化患者和30例非酒精性脂肪肝患者的超声二维及组织结构声学定量图像,利用该技术软件分析并取得相关参数(redmode、redave、redSD、bluemode、blueave、blueSD及FDratio)进行统计学分析。同时,绘制各参数受试者工作特征(ROC)曲线图。结果红线参数在3组两两比较中差异均有统计学意义(P<0.05)。BlueSD在除正常对照组和慢性乙型肝炎性肝硬化组之间外的各组之间差异有统计学意义(P<0.05),bluemode和blueave在3组两两比较中差异均有统计学意义(P<0.05)。FD-ratio值在除正常对照组与非酒精性脂肪肝组之间外的各组之间比较差异有统计学意义(P<0.05)。慢性乙型肝炎性肝硬化组中,ROC评价显示redmode、redave、bluemode及FDratio的曲线下面积(AUC:0.940、0.990、0.745、0.920)均大于0.7,诊断价值较高;各参数诊断界值分别为108.32、111.19、15.50、126.84、145.60、26.82及0.16。非酒精性脂肪肝组中,ROC评价显示各参数的曲线下面积(AUC:0.964、0.951、0.864、0.894、0.852、0.749、0.898)均大于0.7,诊断价值较高;各参数诊断界值分别为100.64、104.31、13.95、119.28、126.99、20.08及0.09。结论ASQ技术作为一种无创、客观的检查新手段,除了可以定量诊断这两种疾病外,各参数在非酒精性脂肪肝病变的诊断中还具有较高的价值。Objective To evaluate the diagnostic value of acoustic structure quantification(ASQ) technique in chronic hepatitis b cirrhosis and non-alcoholic fatty liver disease. Methods Thirty healthy volunteers, forty patients with chronic hepatitis b cirrhosis and thirty patients with non-alcoholic fatty liver disease were examined by ASQ. The ultrasonic two-dimensional and ASQ images were collected and analyzed. The relevant parameters(redmode, redave, redSD, bluemode, blueave, blueSD and FD ratio)were statistically analyzed. Receiver-operating characteristic(ROC)curves were drew for each parameter. Results The difference of red line parameters was statistically significant between each two groups(P<0.05). BlueSD showed statistically significant differences among all groups except the normal control group and the chronic hepatitis b cirrhosis group(P<0.05), while the difference of bluemode and blueave was statistically significant between each two groups(P<0.05). There were statistically significant differences in FD-ratio between all groups except the normal control group and the non-alcoholic fatty liver group(P<0.05). In chronic hepatitis b cirrhosis group,the ROC evaluation showed that the area under the cure(AUC)of redmode, redave, bluemode and FD ratio(0.940, 0.990, 0.745, 0.920)were greater than 0.7, with higher diagnostic value. The corresponding critical values were 108.32,111.19,15.50,126.84,145.60,26.82 and 0.16 respectively. In the non-alcoholic fatty liver group, the ROC evaluation showed that the AUC of each parameter(0.964,0.951,0.864,0.894,0.852,0.749,0.898)was greater than 0.7, indicating higher diagnostic value. The corresponding critical values were 100.64,104.31,13.95,119.28,126.99,20.08 and 0.09 respectively. Conclusion As a new non-invasive and objective examination method, ASQ technology can not only quantitatively diagnose these two diseases, but also has high value in the diagnosis of non-alcoholic fatty liver disease.

关 键 词：组织结构声学定量技术 慢性乙型肝炎性肝硬化 非酒精性脂肪肝 受试者工作特征曲线 

分 类 号：R512.6[医药卫生—内科学] R445.11[医药卫生—临床医学]