实时组织弹性成像定量诊断肝纤维化的初步探讨

目的 探讨实时组织弹性成像(RTE)在肝纤维化诊断中的应用价值.方法 120例正常人为对照组,120例肝纤维化患者,120例肝硬化患者,常规超声和RTE检查其肝脏,记录肝脏弹性图像的弹性参数:相对应变值的平均值(Mean)、相对应变值的标准差(SD)、解析区域蓝色面积百分比(%Area)、蓝色区域复杂度(Comp).将常规超声检查结果与弹性成像评分分别与病理结果进行对照,同时三组超声弹性参数进行比较.结果 弹性成像评分与常规超声诊断肝纤维化的灵敏度分别为90%、53.3%,准确率分别为86.7%、76.7%,弹性成像评分灵敏度、准确率均高于常规超声(P<0.05);弹性成像评分与肝组织病理结果的相关系数为0.893(P=0.000),对照组、肝纤维组、肝硬化组的Mean依次减小,SD、%Area、Comp依次增大,各组间差异均有统计学意义(P<0.01).结论 RTE是一项非侵入性检测肝纤维化的新技术,在肝纤维化诊断中有广阔的应用前景.

Primary study of real-time tissue elastography in quantitative diagnosis of liver fibrosis

Objective To investigate the value of real-time tissue elastography （ RTE ） in diagnosis of liver fibrosis. Methods One hundred and twenty normal control subjects, 120 patients with liver fibrosis and 120 pahents with liver cirrhosis were enrolled in this study. Their livers were examined by conventional ultrasound and RTE. the elastic indexes of liver elastic images were recorded, including mean of relative strain value （Mean） . standard deviation of relative strata value（ SD ） . area ratio of low strain region （ % Area） and complexity of low strain region （ Comp ）. Both of conventional ultrasound results and RTE results were compared with those of pathology, then the elastic indexes of three groups were compared. Results The sensitivity and accuracy rate of conventional-ultrasound in diagnosis of liver fibrosis were 53.3% and 76. 7% . the sensitivity and accuracy rate of RTE in diagnosis of liver fibrosis were 90.0% and 86.7%. The sensitivity and accuracy rate of elastic scores were higher than those of conventional uhrasound（ P〈0.05 ）, the coefficient correlation between the elasticity scores and the stages of liver fibrosis was 0. 893 （ P = 0. 000）. The Mean of the control group, liver fibrosis group and liver cirrhosis group in turn decreased, and SD, % Area and Comp in turn increased, there were significant differences between three groups （ P〈0.01 ）. Conclusion RTE is a noninvasive and promising sonography-based new method in assessment of liver fibrosis.