声速匹配技术及剪切波弹性成像在非酒精性脂肪性肝病及评价肝硬化中的应用  

The application of sound velocity matching technique and shear wave elastography in the evaluation of nonalcoholic fatty liver disease and prediction of cirrhosis

作　　者：顾燕 樊翠翠 王海燕 GU Yan;FAN Cui-cui;WANG Hai-yan(Department of Gastroenterology,Zhangjiagang Aoyang Hospital,Jiangsu 215600,China)

机构地区：[1]张家港澳洋医院消化内科,江苏215600

出　　处：《肝脏》2024年第11期1338-1341,1357,共5页Chinese Hepatology

基　　金：江苏省自然科学基金资助项目(BK20201131)。

摘　　要：目的 分析声速匹配技术(SSC)及剪切波弹性成像(SWE)在评估非酒精性脂肪性肝病(NAFLD)和预测肝硬化中的应用价值。方法 选取2022年7月—2023年7月张家港澳洋医院收治的48例NAFLD患者、50例肝硬化患者,均行SWE技术和SSC技术检查,应用SWE技术检测剪切波速度最大值(Vmax)、平均值(Vmean)及弹性模量值,应用SSC技术检测声速匹配值(ZSI值),对比上述指标差异,分析单一、联合应用各参数诊断肝硬化的效能及SSC、SWE技术检查成功率和耗时时间。结果 肝硬化组回声高32.00%、血流丰富肿块42.00%、血流分级0级0.00%、内部回声不均匀54.00%低于NAFLD组54.17%、62.50%、25.00%、25.00%(P<0.05)。肝硬化组ZSI值(38.46±3.12)m/s、弹性模量值(30.41±3.95)kPa、(3.56±0.34)m/s、Vmean(3.28±0.29)m/s高于(22.63±3.20)m/s、(16.53±2.41)kPa、(2.63±0.24)m/s、(2.51±0.20)m/s(P<0.05)。经ROC曲线分析,ZSI、弹性模量值、Vmax、Vmean、联合诊断肝硬化的灵敏度分别为70.00%、72.92%、72.92%、75.00%、91.67%,特异度分别为72.00%、74.00%、76.00%、78.00%、90.00%。ZSI、弹性模量值、Vmax、Vmean联合诊断肝硬化具有较高的价值(AUC=0.908)。SWE技术检查成功率100.00%高于SSC技术98.98%(P>0.05),SSC技术检查耗时(3.63±0.46)min较SWE技术(4.05±0.51)min短(P<0.05)。结论 SSC技术联合SWE技术在鉴别NAFLD与肝硬化中具有较好的应用价值,对动态观察NAFLD进展有潜在的应用价值。Objective To evaluate the value of sound speed correction(SSC)and shear wave elastography(SWE)in the evaluation of nonalcoholic fatty liver disease(NAFLD)and the prediction of cirrhosis.Methods Forty-eight patients with NAFLD and 50 patients with cirrhosis admitted to Aoyang Hospital in Zhangjiagang from July 2022 to July 2023 were selected and examined with SWE and SSC technologies.The maximum shear velocity(Vmax),average value(Vmean)and elastic modulus values were detected by SWE.Sound velocity matching value(ZSI value)was detected by SSC technique.The difference of the above indexes was compared to analyze the efficacy of single and combined application of each parameter in the diagnosis of cirrhosis,and the success rate and time consuming time of SSC and SWE.Results The echo in the cirrhosis group was higher by 32.00%,the mass with abundant blood flow was 62.5042.00%,the blood flow grade 0 was 0.00%,and the internal echo was not uniform by 54.00%,which was lower than those of 54.17%,42.0062.50%,025.00%,25.00%in the NAFLD group(P<0.05).The values of ZSI(38.46±3.12)m/s,elastic modulus(30.41±3.95)kPa,(3.56±0.34)m/s and Vmean(3.28±0.29)m/s in cirrhosis group were higher than those of(22.63±3.20)m/s,(16.53±2.41)kPa and(2.63±0.24)m/s,(2.51±0.20)m/s(P<0.05).According to ROC curve analysis,the sensitivity of ZSI,elastic modulus,Vmax,Vmean and combined diagnosis of cirrhosis were 70.00%,72.92%,72.92%,75.00%and 91.67%,and the specificity was 72.00%,74.00%,76.00%,78.00%and 90.00%,respectively.The combination of ZSI,elastic modulus,Vmax and Vmean had high value in the diagnosis of cirrhosis(AUC=0.908).The success rate of SWE technique is lower than that of SSC technique(98.98%)(P>0.05),and the time of SSC technique is shorter(4.05±0.51)min than that of SWE technique(3.63±0.46)min(P<0.05).Conclusion SSC technique combined with SWE technique has good application value in differentiating NAFLD and cirrhosis,and has potential application value in dynamic observation of NAFLD progression.

关 键 词：非酒精性脂肪性肝病 声速匹配技术 剪切波弹性成像特点 肝硬化 

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]