新型定量超声技术在非酒精性脂肪肝患者肝脏脂肪变性定量中的应用  

Application of New Quantitative Ultrasound Techniques in the Quantification Liver Steatosis in Patients with Nonalcoholic Fatty Liver Disease

作　　者：汪许红 张盛敏 杨敏 胡寅峰 Wang Xuhong;Zhang Shengmin;Yang Min;Hu Yinfeng(Ningbo First Hospital,Ningbo University School of Medicine,NingBo,Zhejiang 31500.China)

机构地区：[1]宁波大学医学院附属宁波市第一医院,浙江省宁波市315000

出　　处：《中国超声医学杂志》2021年第11期1253-1257,共5页Chinese Journal of Ultrasound in Medicine

摘　　要：目的与常规超声(CUS)和计算机断层扫描(CT)相比,探索定量超声(QUS)技术对肝脏脂肪变性进行准确分级的可行性。方法利用声衰减成像(ATI)、剪切波频散成像(SWD)、剪切波弹性成像(SWE)等QUS技术和常规超声(CUS)评分对186例受试者进行肝脏脂肪变性程度的检测。将QUS参数和CUS评分与3个月内的CT肝脾衰减率(CT_(L/S))进行比较。对ATI、SWD和SWE测量和CUS评分进行观察者间的一致性分析。结果 CT_(L/S)与ATI呈显著负相关(r=-0.907,P<0.001),与SWD、SWE呈轻微相关。CUS和CT的肝脏脂肪变性分级相关系数为0.863。CT诊断的肝脏脂肪变性越严重,ATI数值越高,平均ATI值范围为0.56~0.85 dB/cm/MHz,组间差异有统计学意义(P<0.001)。SWD和SWE组间无显著差异。ATI对肝脏脂肪变性分级有很好的诊断性能,ROC曲线下面积(AUC)为0.912~0.974,P<0.001。QUS参数有很好的观察者间一致性。结论与CUS不同,本研究表明QUS减少了观察者内和观察者间的差异性。ATI可以检测和量化NAFLD患者肝脏脂肪变性的无创技术。Objective To explore the feasibility of using novel quantitative ultrasound(QUS) techniques for accurate grading of liver steatosis compared with conventional ultrasound(CUS) and CT techniques. Methods A total of 186 patients were enrolled. QUS techniques, including attenuation imaging(ATI), shear wave dispersion(SWD), and shear wave elastography(SWE), and CUS scores were utilized to predict the grade of liver steatosis. QUS parameters and CUS scores were compared with the liver-to-spleen attenuation ratio on CT(CT_(L/S)) within three months. Interobserver consistency was analyzed for ATI, SWD, and SWE measurements and CUS scores. Results CT_(L/S) showed a significantly negative correlation with ATI(r=-0.907, P<0.001) and a slight correlation with SWD and SWE. The correlation coefficient of hepatic steatosis grades derived from CUS and CT was 0.863. Based on the different steatosis grades determined by CT, the mean ATI values were 0.56-0.85 dB/cm/MHz and demonstrated gradual progression of steatosis, with significant differences between the groups(P<0.001). There was no significant difference between the SWD and SWE groups. The area under receiver operating characteristic curves(AUCs) for ATI were outstanding(0.912-0.974, P< 0.001). QUS parameters have good consistency. Conclusions Unlike CUS, this study indicates that QUS reduced the intra-and interobserver difference. ATI can detect and quantify the noninvasive technique of liver steatosis in patients with NAFLD.

关 键 词：非酒精性脂肪性肝病 声衰减成像 定量超声技术 

分 类 号：R575.5[医药卫生—消化系统]