基于常规超声参数联合剪切波弹性成像参数的诊断模型预测肝硬化食管静脉曲张的价值  

Value of diagnostic model based on conventional ultrasound parameters combined with shear wave elastography parameters in predicting esophageal varices in cirrhosis

作　　者：吴小芬 方群[1] 周华 周恕敏 WU Xiaofen;FANG Qun;ZHOU Hua;ZHOU Shumin(Department of Ultrasound Medicine,Jianyang Traditional Chinese Medicine Hospital,Sichuan 641400,China)

机构地区：[1]四川省简阳市中医医院超声医学科,641400

出　　处：《临床超声医学杂志》2023年第9期759-763,共5页Journal of Clinical Ultrasound in Medicine

摘　　要：目的探讨基于常规超声参数联合剪切波弹性成像参数的诊断模型预测肝硬化患者发生食管静脉曲张(EV)的临床价值。方法选取我院收治的肝硬化患者132例,依据胃镜检查结果分为无EV组46例和EV组86例,应用常规超声获取肝门静脉内径、肝门静脉流速、脾静脉内径、脾静脉流速;剪切波弹性成像获取肝脏硬度(LS)、脾脏硬度(SS);Child-Pugh分级评估肝硬化程度;比较两组上述检查结果的差异。应用二元Logistic回归分析肝硬化患者发生EV的影响因素并建立联合诊断模型;绘制受试者工作特征(ROC)曲线分析各参数单独应用及联合诊断模型预测肝硬化患者发生EV的效能。结果EV组肝门静脉内径、脾静脉内径、LS、SS均大于无EV组,肝门静脉流速、脾静脉流速均小于无EV组,差异均有统计学意义(均P<0.05)。两组Child-Pugh分级比较差异有统计学意义(Z=-3.917,P<0.001)。二元Logistic回归分析显示Child-Pugh分级、肝门静脉内径、肝门静脉流速、脾静脉内径、LS均为肝硬化患者发生EV的影响因素(均P<0.05)。ROC曲线分析显示,Child-Pugh分级、肝门静脉内径、肝门静脉流速、脾静脉内径、LS单独应用及联合诊断模型预测肝硬化患者发生EV的曲线下面积分别为0.667、0.846、0.820、0.802、0.710、0.997。结论基于常规超声参数联合剪切波弹性成像参数的诊断模型在预测肝硬化患者发生EV中具有较好价值,可为临床诊治提供参考。Objective To explore the clinical value of diagnostic model based on conventional ultrasound parameters combined with shear wave elastography parameters in predicting esophageal varices(EV)in cirrhosis.Methods Totally 132 patients with liver cirrhosis admitted to our hospital were selected,and they were divided into non-EV group(46 cases)and EV group(86 cases)based on the results of gastroscopy.Conventional ultrasound and shear wave elastography were performed in both groups,and the differences of hepatic portal vein diameter,hepatic portal vein velocity,splenic vein diameter,splenic vein velocity,liver hardness(LS)and spleen hardness(SS)were compared.The degree of cirrhosis was evaluated by Child-Pugh grading.The binary Logistic regression was used to analyze the influencing factors of EV in patients with liver cirrhosis,and a combined diagnostic model was established.Receiver operating characteristic(ROC)curve was drawn to analyze the efficacy of each indicator applied alone and combined diagnosis model in predicting EV occurrence in patients with cirrhosis.Results The hepatic portal vein diameter,splenic vein diameter,LS and SS in EV group were higher than those in non-EV group,and the hepatic portal vein velocity and splenic vein velocity were lower than those in non-EV group,the differences were statistically significant(all P<0.05).There was significant difference in Child-Pugh grading between the two groups(Z=-3.917,P<0.001).Binary Logistic regression analysis showed that Child-Pugh grading,hepatic portal vein diameter,hepatic portal vein velocity,splenic vein diameter and LS were the influencing factors of EV occurrence in cirrhosis(all P<0.05).ROC curve analysis showed that the area under the curve of Child-Pugh grading,hepatic portal vein diameter,hepatic portal vein velocity,splenic vein diameter and LS in predicting the occurrence of EV in cirrhosis were 0.667,0.846,0.820,0.802,0.710 and 0.997 by alone application and combined diagnostic model,respectively.Conclusion The diagnostic model based on conv

关 键 词：超声检查 剪切波弹性成像 食管静脉曲张 肝硬化 预测价值 

分 类 号：R445.1[医药卫生—影像医学与核医学] R570.5[医药卫生—诊断学]