摘要
目的探讨超声声辐射力脉冲成像(ARFI)技术测量剪切波速度(SWV)值对大鼠非酒精性脂肪肝(NAFLD)及NAFLD肝纤维化程度的评估价值。方法取36只健康雄性SD大鼠,采用高脂饮食喂养制备NAFLD大鼠模型,行ARFI检查,测量肝右叶组织SWV值;按照NAFLD活动性评分,分为对照组(评分0分,6只)、A组(评分1~2分,单纯性脂肪肝,7只)、B组(评分3~4分,边界,8只)、C组(评分>4分,非酒精性脂肪性肝炎,15只)。比较各组大鼠血生化指标和SWV值的差异,并通过绘制受试者工作特征(ROC)曲线评价ARFI技术对不同阶段NAFLD和肝纤维化的评估价值。结果A、B、C组肝右叶组织SWV值明显高于对照组(P<0.01),C组SWV值明显高于A、B组(P<0.01),而A、B组SWV值比较,并无显著差异(P>0.05)。SWV值鉴别正常大鼠与单纯性脂肪肝的诊断阈值为2.56m/s,其对应的ROC曲线下面积为0.90,敏感度为83.33%,特异度为100.00%,95%CI:0.82~0.98(P<0.01);SWV值鉴别单纯性脂肪肝与非酒精性脂肪性肝炎的诊断阈值为2.93 m/s,其对应的ROC曲线下面积为0.86,敏感度为84.62%,特异度为88.89%,95%CI:0.77~0.95(P<0.01)。SWV值鉴别>F1期肝纤维化、>F2期肝纤维化、>F3期肝纤维化(肝硬化)的诊断阈值分别为3.50 m/s、3.62 m/s、4.52 m/s,其对应的ROC曲线下面积分别为0.96、0.89、0.85,敏感度分别为96.67%、100.00%、100.00%,特异度分别为97.78%、86.25%、80.96%,95%CI:0.92~1.00、0.81~0.98、0.76~0.96(P<0.01)。结论超声ARFI技术测量SWV值可用于评价不同程度的NAFLD及肝纤维化的不同分期,具有良好的评估价值。
Objective To analyze the value of shear wave velocity(SWV)measured by ultrasound acoustic radiation force impulse(ARFI)in evaluating the degree of liver fibrosis in rats with nonalcoholic fatty liver disease(NAFLD)and NAFLD.Methods Thirty-six healthy male SD rats were fed with high-fat diet to prepare NAFLD rat model.The SWV values of right lobe tissues were measured by ARFI.According to NAFLD activity score,the rats were divided into control group(score 0,6 rats),group A(score 1~2,simple fatty liver,7 rats)and group B(score 3~4,boundary,8 rats).Group C(score>4,non-alcoholic steatohepatitis,15 rats).The differences of blood biochemical indexes and SWV values of rats in each group were compared,and the value of ARFI in evaluating NAFLD and liver fibrosis at different stages was evaluated by drawing receiver operating characteristic(ROC)curves.Results The SWV values of right lobe tissues in group A,B and C were significantly higher than those in control group(P<0.01),and those in group C were significantly higher than those in group A and B(P<0.01),but there was no significant difference in SWV values between group A and B(P>0.05).The diagnostic threshold of SWV value was 2.56 m/s,the area under ROC curve was 0.90,the sensitivity was 83.33%,the specificity was 100.00%,95%CI:0.82-0.98(P<0.01).The diagnostic threshold of SWV value was 2.93 m/s for simple fatty liver and non-alcoholic steatohepatitis,and the corresponding ROC curve was 0.93 m/s.The area below was 0.86,the sensitivity was 84.62%,the specificity was 88.89%,and 95%CI:0.77-0.95(P<0.01).The diagnostic thresholds of SWV value were 3.50 m/s,3.62 m/s and 4.52 m/s for stage F1,F2 and F3 hepatic fibrosis(cirrhosis).The corresponding ROC curves were 0.96,0.89 and 0.85,with sensitivity 96.67%,100.00%,100.00%,specificity 97.78%,86.25%,80.96%,respectively.95%CI:0.92-1.00,0.81-0.98,0.76-0.96(P<0.01).Conclusion SWV measurement based on ultrasound ARFI technique can be used to evaluate different degrees of NAFLD and different stages of liver fibrosis,and has good eval
作者
崔娜
崔丽园
张静
CUI Na;CUI Li-yuan;ZHANG Jing(Deparment of Ultrasonic Diagnosis,PLA 960 HOsipital,Ji'nan Shandong 250031,China;Department of Medical Technology,the Northern War Zone Staff,Ji'nan Shandong 250001,China)
出处
《临床和实验医学杂志》
2019年第21期2241-2244,共4页
Journal of Clinical and Experimental Medicine
基金
国家自然科学基金资助项目(编号:81801191)
关键词
大鼠
非酒精性脂肪肝
肝纤维化
声辐射力脉冲成像
剪切波速度
Rats
Nonalcoholic fatty liver
Liver fibrosis
Acoustic radiation force pulse imaging
Shear wave velocity
