剪切波点定量弹性成像技术对慢性乙型肝炎肝纤维化分期的诊断价值

目的 探讨剪切波点定量弹性成像（ElastPQ）技术测量肝组织硬度对诊断慢性乙型肝炎（CHB）肝纤维化分期的价值。方法 选取68例CHB患者为观察对象，24名健康体检者为对照，应用ElastPQ技术进行肝组织硬度检测，获得所有受试者的肝硬度值（ElastPQ值）。以肝穿刺活组织病理结果为金标准，绘制ElastPQ值诊断各肝纤维化分期的ROC曲线，分析其诊断效能。结果 不同分期肝纤维化ElastPQ值差异具有统计学意义（F=9.45，P<0.05），且ElastPQ值与肝纤维化程度呈正相关（r=0.672，P<0.001）。ElastPQ值诊断肝纤维化分期>S0期、>S1-2期、>S3期的界值分别为6.24 kPa、9.20 kPa、15.96 kPa，相应的AUC分别为0.904、0.855、0.772，敏感度分别为93.2%、78.0%、76.3%，特异度分别为100%、89.7%、76.9%。结论 ElastPQ技术可有效评估肝组织弹性硬度，对诊断肝纤维化分期具有重要的临床价值。

Diagnostic value for chronic hepatitis B liver fibrosis based on elastography point quantification technology

Objective To investigate the value of measurement of liver tissue hardness with Elastography point quantification (ElastPQ) technology in the diagnosis of staging of liver fibrosis in chronic hepatitis B (CHB). Methods Totally 68 cases of CHB randomly collected as the observation group, 24 healthy check-up as the control group, liver stiffness measurement (LSM) was performed with ElastPQ technology, liver hardness value (ElastPQ value) of all subjects were obtained. Using liver puncture biopsy pathology as the gold standard, ROC curves of ElastPQ value in the diagnosis of different stages of liver fibrosis were drawn, and the relative diagnostic efficiency were analyzed. Results The differences of ElastPQ value of different stages of hepatic fibrosis had statistical significance (F=9.45, P<0.05). ElastPQ value was positively correlated with the degree of hepatic fibrosis (r=0.672, P<0.001). The threshold values of ElastPQ value in the diagnosis of liver fibrosis stage >S0, >S1-2, >S3 were 6.24 kPa, 9.20 kPa and 15.96 kPa, respectively. The corresponding AUC were 0.904, 0.855 and 0.772, the sensitivity were 93.2%, 78.0% and 76.3%, and the specificity were 100%, 89.7% and 76.9%, respectively. Conclusion ElastPQ technology can effectively evaluate elastic hardness of liver tissue, which has important clinical value for diagnosing liver fibrosis staging.