剪切波弹性成像技术评估非酒精性脂肪性肝病大鼠肝纤维化程度价值的研究  

Study on the Value of Shear Wave Elastography in the Diagnosis of Liver Fibrosis in Rats with Non-alcoholic Fatty Liver Disease

作　　者：石莹 梁婷[1] 林慧 卢海燕[1] 童清平 张锋镝 崔峥[1] Shi Ying;Liang Ting;Lin Hui;Lu Haiyan;Tong Qingping;Zhang Fengdi;Cui Zheng(Department of Ultrasound Intervention,Dongfang Hospital,Tongji University,Shanghai 200135,China;Department of Ultrasonic Diagnosis,The 901 Hospital of the Joint Logistics Support Force of the Chinese people's Liberation Army,Hefei 230001,China)

机构地区：[1]同济大学附属东方医院超声介入科,上海市200135 [2]中国人民解放军联勤保障部队第901医院超声诊断科,合肥市230001

出　　处：《中国超声医学杂志》2024年第1期99-102,共4页Chinese Journal of Ultrasound in Medicine

基　　金：南京军区医学科技创新课题(No.12MA030);浦东新区卫生健康委员会科技项目(No.PW2021A-14)。

摘　　要：目的 探讨剪切波弹性成像(SWE)技术在评估非酒精性脂肪性肝病(NAFLD)大鼠肝纤维化程度的价值。方法 将52只雄性Sprague-Dawley大鼠随机分为实验组40只和对照组12只。实验组喂养蛋氨酸和胆碱缺乏饲料构建NAFLD模型,6 W后采用每周2次腹腔注射四氯化碳橄榄油溶液加速肝纤维化的发生,根据注药时间分为1 W、2 W、3 W和4 W组(各10只)。建模完成后对麻醉及处死状态的大鼠进行SWE测量肝脏硬度,并计算测量结果标准差(SD);解剖大鼠,获得离体状态下肝硬度值(LSM)及SD;切除部分肝脏行病理学检查。应用受试者工作特征(ROC)曲线下面积(AUC)评估不同状态下SWE诊断NAFLD的效能。结果 肝组织病理学检查诊断大鼠F0/F1期非显著性肝纤维化16只,≥F2期显著性肝纤维化33只。非显著性肝纤维化组与显著性肝纤维化组麻醉状态肝脏硬度检测结果SD为(1.79±0.72)kPa、(1.85±1.09)kPa,显著高于处死状态下SD[(0.95±0.51)kPa、(1.13±0.65)kPa,P<0.05],均显著高于离体状态下SD[(0.28±0.14)kPa、(0.32±0.16)kPa,P<0.05];显著性肝纤维化组麻醉、处死和离体状态下LSM分别为(9.72±0.47)kPa、(9.35±0.45)kPa、(2.08±0.07)kPa,显著高于非显著性肝纤维化组[(5.13±0.42)kPa、(4.56±0.42)kPa、(1.31±0.07)kPa],差异均有统计学意义(P<0.05);麻醉、处死和离体状态下LSM诊断显著性肝纤维化AUC分别为0.93、0.94、0.97,灵敏度分别为69.7%、63.6%、66.7%,特异度分别为100%、100%、93.7%。结论 应用SWE评估NAFLD大鼠显著性肝纤维化具有较高的诊断价值,显著性肝纤维化大鼠LSM明显升高;优化仪器性能及测量方法后,SWE在诊断显著性肝纤维化的效能将逐渐提高。Objective The aim of this study was to explore the value of shear wave elastography(SWE)in the diagnosis of liver fibrosis in rats with non-alcoholic fatty liver disease(NAFLD).Methods A total of 52 male Sprague-Dawley rats were randomly divided into the control group(n=12)and the experimental group(n=40).The experimental group was fed with methionine and choline deficiency diet and injected CCl_4 to establish NAFLD models with liver fibrosis.After the completion of the modeling,the liver stiffness of all rats were measured by SWE under anesthesia and after execution.The standard deviation(SD)of the measurements was calculated.Then the rats were dissected to obtain liver stiffness measurement(LSM)and SD in vitro.Part of the liver was resected for pathological examination.The area under the receiver operating characteristic curve was used to evaluate the efficacy of SWE in diagnosing liver fibrosis of NAFLD under different conditions.Results The pathological examination showed F0/F1 non-significant liver fibrosis(NSLF)in 16 rats,and>F2 significant liver fibrosis(SLF)in 33 rats.The SD of NSLF and SLF groups under anesthesia were(1.79±0.72)kPa and(1.85±1.09)kPa,respectively,which were higher than that in the execution state[(0.95±0.51)kPa,(1.13±0.65)kPa]and in the isolated state[(0.28±0.14)kPa,(0.32±0.16)kPa],and the differences were statistically significant(P<0.05).In the SLF group,LSM was(9.72±0.47)kPa under anesthesia,(9.35±0.45)after sacrifice,and(2.08±0.07)kPa in vitro,respectively,higher than that in the NSLF group[(5.13±0.42)kPa,(4.56±0.42)kPa,(1.31±0.07)kPa],and the differences were statistically significant(P<0.05).ROC curve analysis showed that the area under the curve of LSM in the diagnosis of SLF was 0.93,0.94 and 0.97 for anesthesia,execution and in vitro,respectively,and the sensitivity and specificity were 69.7%,63.6%,66.7%and 100%,100%,93.7%,respectively.Conclusions The application of SWE technique in the diagnosis of SLF in NAFLD rat has good application value.

关 键 词：剪切波弹性成像 非酒精性脂肪肝 显著性肝纤维化 离体测量 大鼠 

分 类 号：R575.5[医药卫生—消化系统]