摘要
目的了解肝、胆、脾超声波检查指标与肝脏纤维化程度的相关性,探讨代偿性肝炎后肝硬化超声波筛检诊断组合。方法统计248例慢性肝炎病人超声波检查资料及肝组织病理学诊断,进行回顾性统计学分析。结果肝组织纤维化状态与肝包膜光滑度、门静脉内径无相关性;不同肝组织纤维化状态的肝实质回声均匀度、血管走行、胆囊壁状态及脾大程度有统计学差别;上述4个指标正常时,其肝硬化阴性预告值高达96.3%,评分≥5可筛检出90%代偿性肝硬化,7诊断代偿性肝硬化的准确率85.9%、特异性度高达95.2%,但灵敏度低至37.5%。结论代偿性肝硬化超声波肝实质回声、血管走行、胆囊壁状态及脾大等指标与其他肝纤维化状态有显著差别,其评分系统可作为慢性肝炎病人筛检代偿性肝硬化的灵敏诊断系统。
Objective To investigate the correlation between the stage of hepatic fibrosis and ultrasonographic findings of the liver, spleen and gallbladder and establish a sensitive ultrasonographic semi-quantitative scoring system for screening compensated liver cirrhosis. Methods Totalling 248 patients with chronic hepatitis B and hepatitis C virus infection underwent liver biopsy and ultrasonic examination. The images of the liver surface, parenchymal echo, intrahepatic vessels, gallbladder, spleen and diameter of portal vein were analyzed. Results The stages of hepatic fibrosis were not correlated to ultrasonographic findings of the liver surface or diameter of portal vein, but hepatic fibrosis of different stages showed significant differences in parenchymal echo, intrahepatic vessels, gallbladder and splenomegaly. In cases with normal liver parenchymal, intrahepatic vessels, gallbladder and spleen, the negative predictive value of the ultrasonographic semi-quantitative scoring system for diagnosing compensated liver cirrhosis amounted to 96.3%. The sensitivity of a score not lower than 5 was 90% for detecting compensated cirrhosis. With a score not lower than 7, the diagnostic accuracy and specificity was 85.9% and 95.2%, respectively, but the sensitivity was lowered to 37.5%. Conclusion The ultrasonic images of the liver parenchyma, intrahepatic vessels, gallbladder and spleen in patients with compensated liver cirrhosis vary significanly in patients with hepatic fibrosis of different stages, and this ultrasonographic scoring system allows for a sensitive diagnosis of compensated cirrhosis.
出处
《南方医科大学学报》
CAS
CSCD
北大核心
2006年第8期1200-1202,1208,共4页
Journal of Southern Medical University
关键词
慢性肝炎/病理学
肝硬化/诊断
超声波检查
chronic hepatitis/pathology
liver cirrhosis/diagnosis
ultrasonography
