摘要
目的比較Fibroscan和Ultrasound診斷脂肪肝的一致性和靈敏度。方法回顧性分析在本院健康中心同時進行Fibroscan和Ultrasound檢查肝臟的363例患者,對比兩種檢測方法的診斷結果。結果以臨床常用的Ultrasound診斷的結果作為相對參考標準,Fibroscan的敏感度和特異性分別為87.98%及68.38%。Fibroscan檢出脂肪肝共232例,診斷陽性率為63.9%;Ultrasound檢出脂肪肝共208例,診斷陽性率為57.3%;差別具有統計學意義(P=0.007)。Fibroscan和Ultrasound診斷脂肪肝的一致性一般(Kappa=0.575,P<0.001)。根據Ultrasound結果分組:無脂肪肝組(155例)、輕度脂肪肝組(133例)及中重度脂肪肝組(75例),用秩和試驗比較三個組別的CAP(controlled attenuation parameter),差別具有統計學意義(P=0.001)。結論Fibroscan能夠定量診斷肝脂肪,與Ultrasound在脂肪肝檢測方面相比,有一致性,並且可能有較高的靈敏性,對於臨床上脂肪肝的診斷及監測治療效果具有一定的實用價值。
Objective To evaluate the sensitivity and concordance between the Controlled Attenuation Parameter(CAP)measured by fibroscan and ultrasonography in diagnosing fatty liver.Methods 363 patients who underwent fibroscan and ultrasonography were included in this study.CAP and ultrasound results were compared and analyzed using Kruskal Wallis rank sum test,Chi-square test and Kappa test.Results 232 cases of fatty liver were detected by fibroscan(diagnostic positive rate was 63.9%),whereas only 208 fatty liver cases were detected by ultrasonography(diagnostic positive rate was 57.3%).The difference in detection rate was statistically significant(P=0.007).The concordance of diagnosing fatty liver between fibroscan and ultrasonography was moderate(Kappa=0.575,P<0.001).There were 155 cases of normal,133 cases of mild fatty liver,and 75 cases of moderate to severe fatty liverwere grouped according to ultrasonography.CAP of these groups were compared with the ultrasound using Kruskal Wallis rank sum test,and the difference was statistically significant(P=0.001).Conclusion Diagnosis of fatty liver with use of fibroscan yields quantitative results with higher sensitivity compared to ultrasonography.Fibroscan is considered to have great value in diagnosing fatty liver and clinically monitoring treatment progress of fatty liver.
作者
林肇聰
楊金桃
譚少華
張振榮
LAM Sio Chong David;IEONG Kam Tou;TAM Sio Wa;CHEUNG Chun Wing(Department of Integrated Healthcare Division,Kiang Wu Hospital,Macao,China)
出处
《镜湖医学》
2019年第2期9-11,共3页
MEDICAL JOURNAL OF KIANG WU
