肝纤维化超声造影定量分析中不同形状及不同部位感兴趣区的差异性研究

目的探讨超声造影定量分析中选择不同形状及不同部位感兴趣区测定肝纤维化定量参数有无差异性。方法对30例血清乙型肝炎病毒标志物检测阳性的患者穿刺前行超声造影检查，采集动态造影数据，使用超声造影定量分析软件进行脱机分析。选择同一断面的边缘肝实质、中心肝实质、门静脉主干和肝右静脉分别以椭圆、矩形及不规则形感兴趣区经拟合获得相应的时间-强度曲线（TIC），得到定量参数：强度增量（ISI）、峰值减半斜率（a2）、上升斜率（a3）、开始显影时间（AT）、达峰时间（TTP）、峰值强度（PI）、曲线下面积（AUC）和平均通过时间（MTF）。比较不同形状感兴趣区及边缘与中心肝实质各项定量参数有无差异。结果不同形状感兴趣区的各项参数ISI、a2、a3、AT、TTP、PI、AUC和MTT测值比较差异均无统计学意义（P〉0．05）；边缘肝实质与中心肝实质各项参数中，ISI、a2、AT、PI和AUC测值比较差异有统计学意义（P〈0．05）。结论肝纤维化超声造影定量分析中绘制不同形状感兴趣区对分析结果无影响；边缘肝实质与中心肝实质的微循环灌注不同。

Quantitative assessment of hepatic fibrosis by contrast-enhanced ultrasonography with different regions of interest

Objective To investigate the discrepancy of quantitative parameters on contrast- enhanced ultrasonography （CEUS） with different shapes and positions of region of interest （ROI） in the patients with hepatic fibrosis. Methods Thirty cases of hepatic fibrosis diagnosed pathologically were enrolled in the study. The dynamic images of CEUS stored in hard disk were analyzed off-line with the quantitative software. Three kinds of ROI with elliptic, rectangular and irregular shapes were drawn separately in the same four positions： peripheral liver parenchyma, central liver parenchyma, main portal vein and right hepatic vein. The time intensity curve （TIC） and some quantitative parameters, including increased signal intensity （ ISI）, decent curvature （ a2 ）, up slope rate （ a3 ）, arrival time （ AT）, time to peak （ TIP）, peak intensity （PI）, area under curve （AUC） and mean transit time （MTI） were achieved. Quantitative parameters were compared among different ROIs and between peripheral and central liver parenchyma respectively. Results There was no statistical difference among three shapes of ROIs in all the quantitative parameters of ISI, a2, a3, AT, TIP, PI, AUC and MTT, respectively （P 〉 0.05 ）. The parameters of ISI,a2,AT, PI and AUC were significantly different between＇ peripheral and central liver parenchyma （P 〈 0.05 ）. Conclusions Quantitative parameters of CEUS with different shapes of ROI in hepatic fibrosis have good compatibility;The microcirculation perfusion is different between peripheral and central liver parenchyma.