声辐射力脉冲弹性成像技术与二维剪切波弹性成像技术在评估兔肝脏纤维化等级中的作用

目的探讨声辐射力脉冲成像技术(ARFI)及二维剪切波弹性成像技术(2D-SWE)在诊断肝脏纤维化等级(LF)方面的差异。方法新西兰大白兔60只,随机分为对照组(10只,无处理)和LF组(50只,注射四氯化碳以建立不同程度的LF模型)。利用ARFI及2D-SWE对所有动物进行肝脏硬度(LS)的测定,并取相同部位肝脏组织进行病理学分析,根据Spearman等级相关分析LF及LS之间相关性,通过构建受试者工作特性曲线比较两种技术在诊断效能方面的差异。结果共成功取得37只动物的实验数据,其中F0级14处、F1级11处、F2级15处、F3级12处、F4级22处。所有动物均成功进行LS的测定,LF与ARFI测定结果之间呈线性相关(r=0.802,P<0.01),与2D-SWE测定结果呈线性相关(r=0.892,P<0.01)。成功构建受试者工作特性曲线,ARFI诊断LF>F0、F1、F2、F3的曲线下面积分别为0.809、0.916、0.938、0.934;2D-SWE诊断LF>F0、F1、F2、F3的曲线下面积分别为0.917、0.935、0.976、0.974。结论 ARFI及2D-SWE技术均能较为准确地反应LF的等级,且2D-SWE技术的诊断效能优于ARFI技术。

Roles of Acoustic Radiation Force Impulse and Two-dimensional Shearwave Elastography in Grading Liver Fibrosis in Rabbits

Objective To explore the difference between acoustic radiation force impulse(ARFI)and two-dimensional shearwave elastography(2D-SWE)in grading liver fibrosis(LF).Methods Sixty New Zealand rabbits were divided into control group(n=10;without any treatment)and LF group(n=50;treated with CCl₄ to induce LF at different degrees).Liver stiffness (LS) were measured in all the animals using ARFI and 2D-SWE,and liver tissues in the same sites were collected for pathological analysis.Spearman’s rank-correlation coefficient was used for analysis between LF and LS,and the receiver operating characteristic curve was constructed to analyze the difference of the diagnostic performance of the two techniques.Results Data were obtained from 37 animals,among which 14 sites was at F0,11 sites at F1,12 sites at F3,and 22 sites at F4.All the LS measurements were successfully performed.A significant correlation between LS and ARFI results(r=0.802,P＜0.01)as well as a significant correlation between LF and 2D-SWE results(r=0.892,P＜0.01)were found.The receiver operating characteristic curves were successfully constructed.The area under the curve for diagnosing LF higher than F0,F1,F2 and F3 were 0.809,0.916,0.938,and 0.934,respectively,for ARFI,and those were 0.917,0.935,0.976,and 0.974,respectively,for 2D-SWE.Conclusion ARFI and 2D-SWE can accurately grade LF,and 2D-SWE has a better diagnostic performance than ARFI.