超声造影评价肝纤维化程度的临床应用价值

目的研究超声造影评价慢性乙型肝炎肝纤维化的临床应用价值,筛选与肝纤维化程度密切相关的评估参数。方法选择慢性乙型肝炎患者38例及健康对照组8例在反相脉冲谐波模式下,经肘静脉团注超声造影剂声诺维(SonoVue),测定造影剂到达肝动脉时间(HAAT),到达门静脉时间(PVAT),到达肝静脉时间(HVAT),计算造影剂达到肝动-静脉时间之差即肝动-静脉渡越时间(VAT),肝-门静脉到达时间之差即肝-门静脉渡越时间(VVT)。结果不同程度肝纤维化患者的HAAT、PVAT比较差异无统计学意义。HVAT、VAT、VVT随着肝纤维化程度的加重而缩短(P<0.05),HVAT、VAT、VVT与肝纤维化程度均呈负相关(P<0.01),且VVT相关性最高(r=-0.88)。结论HVAT、VAT、VVT与肝纤维化程度密切相关,尤其是VAT、VVT可作为间接评价肝纤维化程度的指标。

Clinical application value of evaluation liver fibrosis stage by contrast enhanced ultrasound

Objective To study the clinical application value of evaluating chronic hepatitis B liver fibrosis withcontrast enhanced ultrasound and to filter the close parameters.Methods The study included 38 patients with chronic hepatitis B and 8 healthy controls.Under the mode of pulse-inversion harmonic imaging,bolus of ultrasound contrast agent was injected through cubital vein,then hepatic artery arrival time(HAAT),portal vein arrival time(PVAT),hepatic vein arrival time(HVAT)were recorded.The interval time between HAAT and HVAT(VAT) and the interval time between portal VAT and hepatic vein arrival time(VVT) were calculated.Results The HAAT and PVAT showed no correlation with the stage of chronic hepatitis B’ liver fibrosis.The HVAT,VAT,VVT decreased with increase of liver fibrosis(P<0.05).HVAT,VAT,VVT correlated negatively with the development of fibrosis(P<0.01).The correlation coefficient of VVT was highest(r=-0.88).Conclusion HVAT,VAT,VVT are closely associated with the stage of liver fibrosis,especially VAT,VVT can evaluate the stage of liver fibrosis indirectly.