实时剪切波弹性成像在儿童白血病弥漫性肝脏浸润诊治中的应用价值  

Application value of SWE in diagnosis and treatment of diffuse liver infiltration in childhood leukemia

作　　者：李雪娇[1] 樊伟[1] 高鹏[1] 左琼 何文姬[2] LI Xue-Jiao;FAN Wei;GAO Peng(Department of Ultrasound,Children's Hospital,Kunming Medical University,Kunming,Yunnan 650228,China)

机构地区：[1]昆明医科大学附属儿童医院超声科,云南昆明650228 [2]昆明医科大学附属儿童医院心超室,云南昆明650228

出　　处：《中国妇幼保健》2022年第13期2497-2500,共4页Maternal and Child Health Care of China

基　　金：云南省科技厅科技计划项目(202001AY070001-270);云南省高层次卫生健康技术人才医学后备人才培养计划(H-2018012)。

摘　　要：目的 探讨实时剪切波弹性成像(SWE)在儿童白血病弥漫性肝浸润早期诊治中的应用价值。方法 选取50例经骨髓及肝脏穿刺病理证实为白血病弥漫性肝浸润患儿为观察组,同期健康儿童50例作为对照组。采用常规超声及SWE技术检测各组肝实质硬度,取弹性模量平均值(Emean值)进行统计学分析,评价对照组与观察组Emean值的差异;以病理穿刺结果为标准,构建ROC曲线,评价SWE技术对白血病弥漫性肝浸润的早期诊断效能;并随访观察组治疗前后Emean值的变化。结果 观察组与对照组Emean值比较,差异有统计学意义(P<0.05)。观察组内ALL组、AML组、CLL组、CML组弥漫性肝浸润Emean值比较,差异无统计学意义(P>0.05)。以病理穿刺结果为标准,绘制早期诊断弥漫性肝浸润的ROC曲线,其曲线下面积为0.802,诊断阈值为8.15 kPa,特异度为97%,灵敏度为67%。观察组治疗前后Emean值比较,差异有统计学意义(P<0.05)。结论 SWE技术通过定量观察白血病弥漫性肝浸润肝实质硬度变化,有助于对该疾病进行早期诊断并监测疗效。Objective To evaluate the value of real-time shear-wave elastography(SWE) in the early diagnosis and treatment of diffuse liver invasion in childhood leukemia.Methods Select 50 cases confirmed by bone marrow and liver biopsy for leukemia children with diffuse hepatic invasion as observation group, 50 cases of healthy children for the same period as the control group, the conventional ultrasound and SWE technology of groups of liver parenchyma hardness, take the average elastic modulus(Emean) statistical analysis, evaluation of the control group and observation group Emean value difference;Using pathological puncture results as the standard, ROC curve was constructed to evaluate the efficacy of SWE technique in the early diagnosis of leukemia diffuse liver invasion.Emean value of observation group was followed up before and after treatment.Results Comparison of Emean values between the observation group and the control group showed statistical significance(P<0.05).There was no significant difference in the Emean value of diffuse liver invasion in ALL group, AML group, CLL group and CML group(P>0.05).The ROC curve for the early diagnosis of diffuse liver invasion was drawn based on pathological puncture results.The area under the curve was 0.802,the diagnostic threshold was 8.15 kPa, the specificity was 97%,and the sensitivity was 67%.Emean value of observation group before and after treatment was statistically significant(P<0.05).Conclusion The SWE technique is helpful for the early diagnosis of leukemia by quantitatively observing changes in the hardness of liver parenchyma with diffuse hepatic invasion and monitoring the efficacy of the disease.

关 键 词：剪切波弹性成像 白血病弥漫性肝浸润 诊治 应用价值 

分 类 号：R725.5[医药卫生—儿科]