声触诊组织定量技术多肝段检测慢性乙型肝炎肝硬度的应用  

Application of acoustic palpation tissue quantification technology in multi liver segment detection of liver hardness in chronic hepatitis B

作　　者：朱建碧 徐琦 夏建克 陈玲 刘泽政 Zhu Jianbi

机构地区：[1]浙江中医药大学,310053 [2]浙江省温州市人民医院,325000

出　　处：《浙江临床医学》2024年第6期817-819,共3页Zhejiang Clinical Medical Journal

基　　金：温州市基础性医疗卫生科技项目(Y20220076)。

摘　　要：目的应用声触诊组织定量技术(VTQ)多肝段检测慢性乙型肝炎患者肝剪切波速度,探讨VTQ多肝段检测方法诊断肝纤维化中的应用价值。方法选取94例行VTQ检查及肝穿刺活检的慢性乙型肝炎患者,测定右肝前叶下段(S5)、右肝后叶下段(S6)、右肝前叶上段(S8)肝剪切波速度(SWV),根据患者三肝段检测中最大SWV(SWV_(max))和最小SWV(SWV_(min))计算该患者肝段间SWV的最大差异指数(DI),并对各患者三肝段中SWV_(max)和SWV_(min)的肝段进行肝穿刺活检取材。比较患者各肝段间SWV的差异,各肝段间SWV的相关性和一致性,肝SWV与其病理结果的相关性,并将94例患者分为两组,组1患者各肝段SWV一致(DI<20%),组2患者各肝段SWV不一致(DI>20%),比较两组患者三肝段中SWV_(max)、SWV_(min)肝段的SWV值和病理结果。结果肝S5、S6、S8段SWV值差异无统计学意义(P>0.05)。肝S5与S6、S5与S8、S6与S8的SWV值均呈明显的相关性(P<0.01)。两两肝段间SWV值的Bland-Altman散点图显示大多数点都在95%一致性界限内,有个别点在界限外。5个分期的SWV值差异有统计学意义(P<0.05),且SWV值随肝纤维化程度的加重而增高。组1患者SWV_(max)肝段与SWV_(min)肝段的SWV值和病理结果差异均无统计学意义(P>0.05),组2患者SWV_(max)肝段与SWVmin肝段的SWV值和病理结果差异均有统计学意义(P<0.05)。结论VTQ技术多肝段检测方法在更全面评估慢性乙型肝炎患者肝纤维化程度有一定的应用价值。Objective To determine the liver shear wave velocity in patients with chronic hepatitis B by using the acoustic-tactile tissue quantification(VTQ)technique with multiple liver segments,and to explore the value of the VTQ technique with multiple liver segments in the diagnosis of liver fibrosis.Methods 94 patients with chronic hepatitis B who underwent VTQ and hepatic puncture biopsy in our hospital were selected to measure the hepatic shear wave velocity(SWV)in the lower right anterior lobe of the liver(S5),the lower right posterior lobe of the liver(S6),and the upper right anterior lobe of the liver(S8).The SWV maxima and minima of each of these patients'three hepatic segments were used to calculate the index of maximum difference between SWVs of each patient.The maximum difference index(DI)of SWV between the liver segments of each patient was calculated based on the maximum SWV(SWV_(max))and the minimum SWV(SWV_(min))of the three liver segments measured in each patient,and the liver puncture biopsies of the liver segments of each patient were taken.The difference of SWV between liver segments and the correlation of SWV between liver segments of each patient were compared,and the correlation between liver SWV and its pathological results were analyzed.94 patients were divided into two groups,Group 1 patients with consistent SWV in all liver segments(DI<20%),and Group 2 patients with incongruent SWV in all liver segments(DI>20%),and the SWV values of the SWV_(max) and SWV_(min) liver segments in the two groups and the pathological results were respectively were compared and analyzed.Results The LSD-t test showed that the difference in SWV measurements of liver S5,S6 and S8 segments was not statistically significant(P>0.05).The results of correlation test showed significant correlation between hepatic S5 and S6,S5 and S8,and S6 and S8(P<0.01).The results of ANOVA showed that there was a significant difference between the SWV values of the five stages(P<0.05),and the SWV values increased with the aggravation of liv

关 键 词：声触诊组织定量技术 肝硬度 慢性乙型肝炎 

分 类 号：R512.62[医药卫生—内科学] R575.2[医药卫生—临床医学]