摘要
目的:评估超声剪切波弹性成像(SWE)、实时组织弹性成像(RTE)、血清学指标对慢性乙型肝炎肝纤维化程度的诊断价值。方法:回顾性分析69例因慢性乙型肝炎住院患者,收集所有患者的超声弹性成像结果及血清学指标,得出SWE杨氏模量值、RTE弹性指数(LF Index)、AST/ALT(AAR)、AST/PLT(APRI)及FIB-4指数,最后行肝活检术获得肝脏Ishak纤维化分期,比较不同Ishak纤维化分期患者SWE、LF Index、AAR、APRI及FIB-4指数的差异性,采用ROC曲线评价5项肝纤维化诊断指标鉴别慢性乙型肝炎不同Ishak纤维化分期阶段的能力。结果:SWE、LF Index、AAR、APRI及FIB-4指数对肝纤维化的诊断效价在Ishak≥F3及=F6组间比较差异有统计学意义(P<0.05);鉴别诊断肝Ishak F3的ROC曲线下面积(AUC)从大到小分别为SWE(0.910)、FIB-4(0.859)、LF Index(0.724)、APRI(0.709)、AAR(0.657);鉴别肝Ishak F6的AUC从大到小分别为SWE(0.962)、FIB-4(0.907)、APRI(0.811)、LF Index(0.810)、AAR(0.785)。结论:SWE、RTE、血清学指标(AAR、APRI、FIB-4指数)均是临床诊断及鉴别诊断慢性乙型肝炎肝纤维化程度的良好评价方法,SWE技术优于其他技术。
Objective:To evaluate the diagnosis value of Ultrasonic shearwave elastic imaging(SWE),Real-time tissue elastography(RTE),serological indexes:aspartate aminotransferase-to-alanine aminotransferase ratio(AAR),aspartate aminotransferase-to-platelet ratio index(APRI)and fibrosis index based on the 4 factors(FIB4)in detecting the degree of liver fibrosis in patients with chronic hepatitis B.Methods:69 patients with chronic hepatitis B viral infection were retrospectively analyzed.The histopathologic examinations of liver biopsies were performed in all of them.The liver fibrotic stage(Ishak)were obtained.And the elastic modulus value,the LF Index and other serological indicators were also recorded.AAR,APRI and FIB-4 were calculated for each group.To compare the differences of SWE,LF Index,AAR,APRI and FIB-4 index in patients with different stages of Ishak fibrosis.In addition,the performances of these fibrosis indexes in different subgroups were investigated in chronic hepatitis B by ROC curve.Results:SWE,LF Index,AAR,APRI and FIB-4 index could significance distinguish between two groups(≥F3 or=F6),respectively(P<0.05).The under ROC curve areas of SWE,FIB4,LF Index,APRI and AAR for differential stages of liver fibrosis F03 and F46 were 0.910,0.859,0.724,0.709,0.657,respectively.The under ROC curve areas of SWE,FIB4,APRI,LF Index and AAR for differential diagnosis of liver fibrosis=F6 were 0.962,0.907,0.811,0.810,0.785,respectively.Conclusion:These results demonstrated that SWE,RTE,AAR,APRI and FIB4 index could be used for assessing liver fibrosis inpatients with chronic hepatitis B.SWE is especially superior to other products.
作者
柳刚
贺军
申学舟
邵克忠
黄晓斌
陈利民
LIU Gang;HE Jun;SHEN Xue-zhou;CHEN Li-min(Department of Ultrasound,Wenzhou Central Hospital,Wenzhou Zhejiang,325000,China)
出处
《中西医结合肝病杂志》
CAS
2021年第4期335-337,348,共4页
Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases
基金
温州市科技计划项目(No.2017Y0440)。
关键词
肝炎
乙型
肝硬化
弹性成像技术
血清学试验
hepatitis B
Liver cirrhosis
Ultrasound elastography
serological test
