超声平面波技术评估慢性肝病患者肝脏脂肪变程度的有效性分析  

Diagnostic Value of Ultrasonic Plane Wave Imaging in Assessing the Degree of Hepatic Steatosis in Patients with Chronic Liver Disease

作　　者：马晨瑶 潘国栋 殷志勇[1] 王米雪 李墨 张瑶[1] Ma Chenyao;Pan Guodong;Yin Zhiyong;Wang Mixue;Li Mo;Zhang Yao(Department of Ultrasound,Beijing Ditan Hospital Affiliated to Capital Medical University,Beijing 100015,China)

机构地区：[1]首都医科大学附属北京地坛医院超声科,北京市100015

出　　处：《中国超声医学杂志》2024年第9期1005-1008,共4页Chinese Journal of Ultrasound in Medicine

基　　金：首都医科大学附属北京地坛医院院内科研基金(No.DTYM-202401);首都医科大学附属北京地坛医院科技成果转化培育专项(No.DTTP-202302)。

摘　　要：目的本研究探讨超声平面波技术对慢性肝病患者肝脏脂肪变程度的诊断价值。方法收集行肝脏穿刺活检的87例患者的临床及影像资料并进行前瞻性分析。对受控衰减参数(CAP)、平面波声衰减(Att PLUS)、平面波声速测定(SSp PLUS)及B-Mode Ratio 4个参数和穿刺病理结果得出的肝脏脂肪变程度进行Pearson相关性分析。根据穿刺病理有无脂肪变将患者分为病例组(58例)和对照组(29例),绘制4个超声参数诊断肝脏脂肪变的受试者工作特征(ROC)曲线,计算曲线下面积(AUC)及截断值。结果4个超声指标均与肝脏脂肪变程度显著相关(P≤0.001)。CAP、Att PLUS、SSp PLUS及B-Mode Ratio诊断有无脂肪变的阈值分别为213 dB/m、0.385 dB/(cm·MHz)、1539 m/s和1.025;曲线下面积分别为0.883、0.916、0.678和0.720。结论在慢性肝病患者中,CAP、Att PLUS、SSp PLUS及B-Mode Ratio与肝脏脂肪变程度具有良好的相关性,其中Att PLUS是诊断慢性肝病患者有无脂肪变最有价值的指标。Objective This study aims to explore the diagnostic value of ultrasonic plane wave imaging on the de-gree of hepatic steatosis in patients with chronic liver disease.Methods Clinical and imaging data of 87 patients who underwent liver biopsy were collected and were prospectively analyzed.The Pearson correlation analysis was conducted on the four parameters of controlled attenuation parameter(CAP),attenuation plane-wave ultrasound(Att PLUS),sound speed plane-wave ultrasound(SSp PLUS),and B-Mode Ratio with the degree of hepatic steatosis obtained from the pathology results.Patients were divided into cases(58 patients)and control group(29 patients).Receiver operat-ing characteristic(ROC)curves of four ultrasound parameters to diagnose hepatic steatosis were drawn,and the area under the curve(AUC)and cutoff values were calculated.Results The four ultrasound indexes were significantly as-sociated with the degree of hepatic steatosis(P≤0.001).The thresholds for the diagnosis of CAP,Att PLUS,SSp PLUS and B-Mode Ratio were 213 dB/m,0.385 dB/(cm·MHz),1539 m/s and 1.025,respectively,the area under the curve was 0.883,0.916,0.678 and 0.720,respectively.Conclusions In patients with chronic liver disease,CAP,Att PLUS,SSp PLUS and B-Mode Ratio have a good correlation with the degree of hepatic steatosis.Att PLUS is the most valuable indicator for diagnosing the presence of hepatic steatosis.

关 键 词：平面波声衰减 平面波声速测定 肝肾回声比 慢性肝病 脂肪变程度 

分 类 号：R445.1[医药卫生—影像医学与核医学] R575[医药卫生—诊断学]