磁共振弹性成像测量脾脏硬度及脾脏体积对慢性乙型肝炎患者肝纤维化分期的评价  

Evaluation of liver fibrosis stage in chronic hepatitis B patients by spleen stiffness and volume measurement with magnetic resonance elastography

作　　者：王天宝 魏海港 徐新胜 WANG Tian-bao;WEI Hai-gang;XU Xin-sheng(Department of Imaging,Tongxu First Hospital,Henan 475400,China;Department of Imaging,Huaihe Hospital Affiliated to Henan University,Henan 475000,China;Department of Imaging,Kaifeng Cancer Hospital,Henan 475000,China)

机构地区：[1]通许第一医院影像科,河南475400 [2]河南大学附属淮河医院影像科 [3]开封市肿瘤医院影像科

出　　处：《肝脏》2022年第4期443-446,共4页Chinese Hepatology

基　　金：2019年度河南省医学科技攻关计划联合共建项目(LHGJ20191337)。

摘　　要：目的通过磁共振弹性成像(MRE)测量脾脏硬度值(SSM)、脾脏体积评价慢性乙型肝炎(CHB)患者肝纤维化分期。方法纳入2018年1月至2021年4月完成MRE检查CHB患者92例(男70例、女22例),年龄(42.1±6.0)岁。根据资料类型,采用t检验/卡方检验比较。结果比较CHB患者(CHB组)、对照组资料,CHB组、对照组SSM值为(5.1±1.2)kPa、(4.4±0.9)kPa,差异具有统计学意义(P<0.05);CHB组、对照组脾脏体积为(210.3±37.1)cm^(3)、(180.6±30.8)cm^(3),差异具有统计学意义(P<0.05);CHB组血小板(PLT)、谷丙转氨酶(ALT)、谷草转氨酶(AST)、碱性磷酸酶(ALP)及谷氨酰转肽酶(GGT)为(130.8±32.3)×10^(9)/L、(55.8±18.4)U/L、(52.1±16.1)U/L、(158.2±42.1)U/L及(63.1±20.7)U/L,与对照组[(182.5±40.6)×10^(9)/L、(28.4±11.1)U/L、(24.6±9.6)U/L、(92.0±30.6)U/L及(36.2±12.9)U/L]比,差异具有统计学意义(P<0.05)。F3[(5.8±1.3)kPa]、F4期[(6.8±1.5)kPa]CHB患者SSM值分别显著高于F0[(4.4±1.0)kPa]、F1[(4.5±0.9)kPa]及F2期[(4.6±1.2)kPa](P<0.05);F3[(246.1±43.1)cm^(3)]、F4期[(272.2±49.2)cm^(3)]CHB患者脾脏体积分别显著高于F0[(186.5±32.2)cm^(3)]、F1[(192.3±33.5)cm^(3)]及F2期[(198.4±35.0)cm^(3)](P<0.05)。结论MRE测量SSM、脾脏体积对CHB患者肝纤维化分期具有重要临床价值,特别是对于晚期肝纤维化的评价。Objective The staging of liver fibrosis in patients with chronic hepatitis B(CHB)was evaluated by spleen stiffness measurement(SSM)and spleen volume with magnetic resonance elastography(MRE).Methods A total of 92 CHB patients(70 males and 22 females)who completed MRE examination from January 2018 to April 2021 were enrolled,with an average age of(42.1±6.0)years.T test or chi-square test was used for statistical comparison according to the data type.Results When comparing the data of CHB patients(CHB group)and control group,the SSM values of CHB group and control group were(5.1±1.2)kPa and(4.4±0.9)kPa,respectively,and the difference was statistically significant(P<0.05).The volume of spleen in CHB group and control group was(210.3±37.1)cm^(3) and(180.6±30.8)cm^(3),respectively,and the difference was statistically significant(P<0.05).The levels of platelet(PLT)count,alanine aminotransferase(ALT),aspartate transaminase(AST),alkaline phosphatase(ALP)and glutamyl transpeptidase(GGT)in CHB group were(130.8±32.3)×10^(9)/L,(55.8±18.4)U/L,(52.1±16.1)U/L,(158.2±42.1)U/L,compared with the control group[(182.5±40.6)×10^(9)/L,(28.4±11.1)U/L,(24.6±9.6)U/L,(92.0±30.6)U/L and(36.2±12.9)U/L],respectively,the differences were statistically significant(P<0.05).The SSM values of CHB patients in F3[(5.8±1.3)kPa]and F4[(6.8±1.5)kPa]were significantly higher than those in F0[(4.4±1.0)kPa],F1[(4.5±0.9)kPa]and F2[(4.6±1.2)kPa],respectively,with all P<0.05.The volume of spleen in patients with CHB in F3[(246.1±43.1)cm^(3)]and F4[(272.2±49.2)cm^(3)]was significantly higher than that in F0[(186.5±32.2)cm^(3)],F1[(192.3±33.5)cm^(3)]and F2[(198.4±35.0)cm^(3)],respectively,with all P<0.05.Conclusion Measurement of SSM and spleen volume by MRE has important clinical value for staging liver fibrosis in CHB patients,especially for the evaluation of advanced liver fibrosis.

关 键 词：慢性乙型肝炎 磁共振弹性成像 肝纤维化分期 脾脏硬度值 脾脏体积 

分 类 号：R51[医药卫生—内科学]