腹部超声弹性成像指标与老年非均匀性脂肪肝严重程度的关系研究  

Relationship between abdominal ultrasound elastographic index andseverity in senile heterogeneous fatty liver disease

作　　者：李恒 尚晓娜 LI Heng;SHANG Xiaona(Department of Ultrasound,Central Hospital of Tongchuan Mining Bureau,Tongchuan,Shaanxi 727000,China;Department of Ultrasound Medicine,Shaanxi Provincial Second People′s Hospital,Xi′an,Shaanxi 710000,China)

机构地区：[1]陕西省铜川矿务局中心医院超声科,陕西铜川727000 [2]陕西省第二人民医院超声医学科,陕西西安710000

出　　处：《检验医学与临床》2023年第24期3642-3647,共6页Laboratory Medicine and Clinic

摘　　要：目的 研究腹部超声弹性成像指标与老年非均匀性脂肪肝严重程度的关系。方法 选择2020年8月至2022年8月经铜川矿务局中心医院及陕西省第二人民医院超声科检查且经病理证实为老年非均匀性脂肪肝患者100例(观察组)及体检健康的老年人50例(对照组)进行回顾性分析。观察组按病情严重程度分为轻度组、中度组及重度组。所有受试者均实施腹部超声弹性成像检查,经组织弥散定量分析软件获取弹性特征量指标[包括应变均值(Mean)、标准偏差(Sd)、复杂度(Comp)、峰度(Kurt)、偏度(Skew)、对比度(Cont)、均等性(Ent)、杂乱度(Idm)、一致性(Asm)、相关性(Corr)、蓝色区域百分比(%Area)及弹性指数(Lf index)]进行比较,采用Spearman相关分析弹性特征量指标与老年非均匀性脂肪肝严重程度的相关性,绘制受试者工作特征(ROC)曲线评估Mean、Sd、%Area、Lf index对老年非均匀性脂肪肝严重程度的预测价值。结果 观察组和对照组Kurt、Cont比较,差异均无统计学意义(P>0.05);观察组和对照组Mean、Sd、Comp、Skew、Ent、Idm、Asm、Corr、%Area及Lf index比较,差异均有统计学意义(P<0.05)。轻度组、中度组、重度组间Skew、Idm、Corr比较,差异均无统计学意义(P>0.05);轻度组、中度组、重度组间Mean、Sd、Comp、Ent、Asm、%Area及Lf index比较,差异均有统计学意义(P<0.05)。Spearman相关分析结果显示,Lf index、%Area、Mean、Sd与老年非均匀性脂肪肝严重程度的相关性较高(r=0.633、0.492、-0.460、0.373,P<0.05)。%Area预测重度非均匀性脂肪肝的AUC最大,为0.920(95%CI:0.866~0.974),其预测效能与Lf index相当(P=0.329),优于Mean[AUC为0.780 (95%CI:0.678~0.882)]及Sd[AUC为0.752 (95%CI:0.631~0.873)],差异均有统计学意义(P=0.043、0.031)。Lf index、%Area、Mean、Sd预测中至重度非均匀性脂肪肝的AUC分别为0.801(95%CI:0.714~0.887)、0.667(95%CI:0.562~0.773)、0.731(95%CI:0.633~0.829)、0.678(95%CI:0Objective To study the relationship between the abdominal ultrasound elastographic indexes and the severity of senile eterogeneous fatty liver disease.Methods One hundred patients with pathologically confirmed senile eterogeneous fatty liver disease admitted and treated in the Central Hospital of Tongchuan Mining Bureau and the Shaanxi Provincial Second People′s Hospital from August 2020 to August 2022(observation group)and the healthy elderly subjects in the physical examination(control group)were selected to conduct the retrospective analysis.The observation group was sub divided into the mild group,moderate group and severe group according to the severity of the condition.All subjects performed the abdominal ultrasound elastography.The elastic characteristic indexes[including strain mean(Mean),standard deviation(Sd),complexity(Comp),kurtosis(Kurt),skewness(Skew),contrast(Cont),evenness(Ent),clutter(Idm),consistency(Asm),correlation(Corr),blue area percentage(%Area)and elasticity index(Lf index)]were obtained by the tissue dispersion quantitative analysis software and conducted the comparison.The Spearman relation was adopted to analyze the correlation between the elastic characteristic indexes and the severity of senile heterogeneous fatty liver disease,Furthermore,the predictive value of Mean,Sd,%Area and Lf index in predicting the severity of senile heterogeneous fatty liver disease was evaluated by the receiver operating characteristic(ROC)curve.Results There was no statistically significant difference in Kurt and Cont between the observation group and control group(P>0.05);the elastic characteristic indicators such as Mean,Sd,Comp,Skew,Ent,Idm,Asm,Corr,%Area and Lf index had statistical differences between the observation group and control group(P<0.05).There was no statistically significant difference in Skew,Idm and Corr among the mild,moderate and severe groups(P>0.05);there were statistically significant differences in Mean,Sd,Comp,Ent,Asm,%Area and Lf index among the mild,moderate and severe groups(

关 键 词：非均匀性脂肪肝 老年 腹部超声 弹性成像指标 

分 类 号：R575.5[医药卫生—消化系统]