声触诊弹性成像和声速匹配技术在非酒精性脂肪性肝病和肝硬化中的诊断价值  

Evaluation of non-alcoholic fatty liver disease and cirrhosis by sound touch elastography and sound speed correction

作　　者：黄国庆[1] 高枫[1] 孙燕[2] 袁华琴[1] 程正才[1] 胡佩佩 于群 HUANG Guoqing;GAO Feng;SUN Yan;YUAN Huaqing;CHENG Zhengcai;HU Peipei;YU Qun(Department of Ultrasonography,Affiliate Hospital of Hangzhou Normal University,Hangzhou 310015,China)

机构地区：[1]杭州师范大学附属医院超声医学科,310015 [2]杭州市职业病防治院特检科

出　　处：《浙江医学》2021年第19期2100-2103,I0006,共5页Zhejiang Medical Journal

基　　金：浙江省基础公益研究计划项目(LGF18H180014)。

摘　　要：目的探讨声触诊弹性成像(STE)和声速匹配技术(SSC)在无创评价非酒精性脂肪性肝病(NAFLD)和肝硬化中的可行性及临床应用价值。方法选取2018年6月至2020年12月杭州师范大学附属医院诊治的NAFLD患者52例(NAFLD组)、肝硬化患者32例(肝硬化组)和健康体检者38例(对照组),均行STE和SSC检查,比较3组肝组织弹性模量(E值)与声速指数(SSI)的差异,分析STE和SSC的诊断效能,并比较两种方法检查成功率和耗时。结果3组间E值与SSI的差异均有统计学意义(H=69.455、34.163,均P<0.01)。NAFLD组与对照组E值和SSI的差异均有统计学意义(H=-17.939、19.388,均P<0.05)。NAFLD组与肝硬化组E值和SSI的差异均有统计学意义(H=-50.915、-46.519,均P<0.01)。STE和SSC判别肝硬化的AUC分别为0.981(95%CI:0.956~1.000)、0.859(95%CI:0.781~0.938)。结论STE和SSC无创评价NAFLD和肝硬化是可行的,对于动态观察NAFLD进展有潜在临床应用价值。Objective To investigate the application of sound touch elastography(STE)and sound speed correction(SSC)in non-invasive evaluation of non-alcoholic fatty liver disease(NAFLD)and cirrhosis.Methods Fifty patients with NAFLD(NAFLD group),32 patients with cirrhosis(cirrhosis group)and 38 healthy subjects(control group)were enrolled from the Affiliate Hospital of Hangzhou Normal University from June 2018 to December 2020.All subjects underwent STE and SSC examinations.Clinical data,liver tissue Young's modulus(E value)and sound speed index(SSI)were documented,and the differences among the three groups were compared.The diagnostic efficacy of STE and SSC for NAFLD and cirrhosis was analyzed.Results There were significant differences in Young's modulus(E value)and the sound speed index(SSI)among three groups(H=69.455,34.163,both P<0.01).There were significant differences in the E value and SSI between control group and NAFLD group(H=-17.939,19.388,both P<0.05),and between cirrhosis group and NAFLD group(H=-50.915,-46.519,both P<0.01).ROC curve analysis showed that the diagnostic efficiency of STE was higher than that of SSC.Conclusion STE and SSC are feasible for non-invasive evaluation of NAFLD,and have potential clinical application value for dynamic monitoring of the progress of NAFLD.

关 键 词：声触诊弹性成像 声速匹配技术 非酒精性脂肪性肝病 肝硬化 

分 类 号：R445.1[医药卫生—影像医学与核医学] R575.5[医药卫生—诊断学] R575.2[医药卫生—临床医学]