常规超声联合瞬时弹性成像预测肝移植患者早期同种异体移植物功能障碍的临床价值  

Clinical value of conventional ultrasound combined with transientelastography in the prediction of early allograft dysfunction inpatients after liver transplantation

作　　者：杨子祯 王艺颖 吴晓冬[1] 蔡金贞 王建红[1] YANG Zizhen;WANG Yiying;WU Xiaodong;CAI Jinzhen;WANG Jianhong(Organ Transplantation Center,Affiliated Hospital of Qingdao University,Shandong 266100,China)

机构地区：[1]青岛大学附属医院器官移植中心,山东省青岛市266100 [2]青岛市妇女儿童医院妇产超声科

出　　处：《临床超声医学杂志》2024年第2期120-124,共5页Journal of Clinical Ultrasound in Medicine

基　　金：青岛大学附属医院青年科研基金项目(QYFY-2021-36)。

摘　　要：目的 探讨常规超声联合瞬时弹性成像预测肝移植患者早期同种异体移植物功能障碍(EAD)的临床价值。方法 回顾性分析我院37例脑死亡器官捐献(DBD)供者肝脏(以下简称供肝)影像学资料,所有供肝移植前均行常规超声及瞬时弹性成像检查获取超声分级、受控衰减参数(CAP)、肝脏硬度值(LS),根据相应受者术后1周内是否发生EAD将其分为EAD组17例和非EAD组20例,比较两组供肝超声分级、CAP及LS的差异。绘制受试者工作特征(ROC)曲线分析供肝超声分级、CAP、LS单独及联合预测肝移植患者EAD的诊断效能。结果 EAD组供肝CAP、LS及超声分级均高于非EAD组,差异均有统计学意义(均P<0.05)。ROC曲线分析显示,供肝CAP、LS、超声分级截断值分别为206 dB/m、5.5 kPa、3.5级时,预测肝移植患者EAD的曲线下面积(AUC)分别为0.854、0.729、0.762,供肝超声分级联合CAP、LS预测肝移植患者EAD的AUC最高,为0.888,与供肝超声分级、LS的AUC比较差异均有统计学意义(均P<0.05);其余两两比较差异均无统计学意义。结论 常规超声联合瞬时弹性成像在预测肝移植患者EAD中有一定的临床价值。Objective To explore the clinical value of conventional ultrasound combined with transient elastography in the prediction of early allograft dysfunction(EAD)in patients after liver transplantation.Methods The imaging data of 37 cases of donor liver from donation after brain death(DBD)in our hospital were analyzed retrospectively.The donor liver underwent conventional ultrasound and transient elastography before liver transplantation to obtain ultrasound grading,controlled attenuation parameter(CAP)and liver stiffness(LS).According to the occurrence of allograft dysfunction(EAD)within 1 week after surgery,the recipients were divided into EAD group(17 cases)and non-EAD group(20 cases).The differences in ultrasound grading,CAP,and LS of donor liver between the two groups were compared.Receiver operating characteristic(ROC)curve was drawn to evaluate the diagnostic accuracy of ultrasound grading,CAP,and LS alone or in combination in predicting EAD in patients after liver transplantation.Results The CAP,LS and ultrasound grading of donor liver in the EAD group were significantly higher than those in the non-EAD group(all P<0.05).ROC curve analysis showed that when the cut-off values of CAP,LS and ultrasound grading of donor liver were 206 dB/m,5.5 kPa and 3.5 grading,the area under the curve(AUC)of EAD in patients after liver transplantation were 0.854,0.729 and 0.762,respectively.The AUC of ultrasound grading combined with CAP and LS was the highest(0.888),which was significantly different from that of ultrasound grading and LS of donor liver(both P<0.05). However,there were no significant differences in rest pairwise comparisons.Conclusion The combination of conventional ultrasound and transient elastography has a certain clinical value in theprediction of EAD after liver transplantation.

关 键 词：超声检查 瞬时弹性成像 超声分级 肝移植 早期同种异体移植物功能障碍 

分 类 号：R445.1[医药卫生—影像医学与核医学] R657.3[医药卫生—诊断学]