摘要
目的探讨瞬时弹性成像和二维剪切波弹性成像用于CHB患者肝纤维化诊断的临床价值。方法2016年3月~2018年12月我院收治的CHB患者164例,均行瞬时弹性成像和二维剪切波弹性成像检查及肝穿刺活检,采用受试者工作特性(ROC)曲线下面积比较两种超声弹性成像检查诊断不同肝纤维化分期的效能。结果经肝穿刺活检,在164例CHB患者中,诊断肝组织S 1期50例,S 2期42例,S 3期39例,S 4期33例;瞬时弹性成像检查S 1~S 4期肝纤维化分期的弹性值分别为(6.5±1.1)kPa、(8.6±1.4)kPa、(11.7±1.8)kPa和(16.3±1.8)kPa,二维剪切波弹性成像检查弹性值分别为(5.9±0.8)kPa、(8.1±1.2)kPa、(10.9±1.5)kPa和(16.7±1.9)kPa,两种超声弹性成像检查不同肝纤维化分期弹性值差异无统计学意义(P>0.05);二维剪切波弹性成像检查诊断肝纤维化S 2、S 3和S 4期的ROC曲线下面积(AUC)分别为0.971、0.979和0.973,显著高于瞬时弹性成像检查的0.902、0.906和0.904(P<0.05),其诊断的敏感性分别为90.3%、90.6%和100.0%,特异性分别为95.8%、90.6%和84.5%,而瞬时弹性成像检查诊断则分别为78.5%、81.3%和73.1%,和93.3%、87.9%和91.0%。结论二维剪切波弹性成像和瞬时弹性成像检查均可用于慢性乙型肝炎患者的肝纤维化诊断,其临床价值均需要进一步探讨。
Objective The purpose of this study was to investigate the clinical value of transient elastography(TE)and two-dimensional shear wave elastography(SWE)in the diagnosis of liver fibrosis in patients with chronic hepatitis B(CHB).Methods 164 patients with CHB B were enrolled in our hospital between March 2016 and December 2018,and all patients underwent HE and SWE.The liver biopsy was also performed.The area under ROC curve(AUC)was applied to analyze the diagnostic performance.Results The liver histopathological examination showed liver fibrosis S 1 in 50,S 2 in 42,S 3 in 39 and S 4 in 33 in our series;the liver stiffness measurement(LSM)of patients with S 1,S 2,S 3 and S 4 by TE were(6.5±1.1)kPa,(8.6±1.4)kPa,(11.7±1.8)kPa and(16.3±1.8)kPa,and by SWE were(5.9±0.8)kPa,(8.1±1.2)kPa,(10.9±1.5)kPa and(16.7±1.9)kPa(P>0.05);the AUC of SWE in diagnosing S 2,S 3 and S 4 were 0.971,0.979 and 0.973,much higher than 0.902,0.906 and 0.904(P<0.05)by TE,and the sensitivities were 90.3%,90.6%and 100.0%,and the specificities were 95.8%,90.6%and 84.5%,while they were 78.5%,81.3%and 73.1%,and 93.3%,87.9%and 91.0%,respectively,by TE.Conclusion The application of TE and SWE in the diagnosis of liver fibrosis in patients with CHB might possess a efficient performance in clinical practice.
作者
叶细容
吕志红
江峰
解育新
Ye Xirong;Lyu Zhihong;Jiang Feng(Department of Ultrasound,Central Hospital of Eastern Hubei Medical Group,Huangshi 435000,Hubei Province,China)
出处
《实用肝脏病杂志》
CAS
2020年第1期18-21,共4页
Journal of Practical Hepatology
基金
黄石市卫生医药科技发展计划项目(编号:392339)
关键词
慢性乙型肝炎
肝纤维化
瞬时弹性成像
二维剪切波弹性成像
诊断
Hepatitis B
Transient elastography
Two-dimensional shear wave elastography
Hepatic fibrosis
Diagnosis
