声辐射力脉冲成像技术评价肝脏纤维化及早期肝硬化的初步研究

目的 探讨运用声辐射力脉冲成像技术( ARFI)评价肝脏纤维化及早期肝硬化的价值.方法 选取66例经肝穿活检证实的病毒性肝炎患者与33例健康者正常对照组(S0),应用声辐射力脉冲成像技术测量受检者肝脏s5、s6、s7、s8段及肝包膜的剪切波速度,同时常规测量所有受检者的肝、脾大小及门静脉内径.结果 66例病毒性肝炎患者按照肝穿活检病理结果分为S1组、肝脏纤维化组(S2-S3)、早期肝硬化组(S4).早期肝硬化组(S4)的肝脏各段剪切波速度与S0组、S1组、肝脏纤维化组(S2-S3)间的相应肝段剪切波速度均存在统计学差异(P＜0.05),肝脏纤维化组(S2-S3)与S0组、S1组间的相应肝段剪切波速度也均存在统计学差异(P＜0.05),而S1组与S0组间的各肝段剪切波速度无统计学差异(P＞0.05),各组间肝包膜剪切波速度无统计学差异(P＞0.05).早期肝硬化组的脾脏厚度及门静脉内径较其他组有增加,并具统计学差异(P＜0.05).结论 声辐射力脉冲成像技术可无创评价病毒性肝炎患者肝脏纤维化及早期肝硬化程度,方法可行,适合于临床推广应用.

Acoustic radiation force impulse for evaluation of hepatic fibrosis and early stage cirrhosis

Objective To investigate the value of acoustic radiation force impulse （ARFI） in evaluating the stage of hepatic fibrosis and early stage cirrhosis. Methods Sixty-six patients with viral hepatitis underwent liver biopsy and 33 normal subjects （S0） were selected to accept ARFI, the shear wave velocity of hepatic segments S5, S6,S7 ,S8 and size of liver were measured. The results of liver and spleen size and portal vein＇s diameter were also measured. Results The 66 patients were divided into 3 groups：S1, S2- S3,S4. ARFI for 66 patients and 33 normal subjects showed good image quality. There were statistically significant differences between S4 group and SO group, Slgroup,S2-S3 group for the shear wave velocity of hepatic segments S5, S6, S7, S8 （ P 〈 0.05 ）. Between S2-S3 group and SO group S1 group, the shear wave velocity of hepatic segments S5, S6, S7, S8 also have statistically significant differences （ P 〈 0. 05 ）, other parameters showed no significant difference （ P 〉 0.05 ）. Spleen size and the portal vein＇s diameter of S4 group were larger than those in other groups （P 〈 0. 05）. Conclusions The invasive acoustic radiation force impulse could evaluate the stage of hepatic fibrosis and early stage cirrhosis in patients suffering from viral hepatitis. The measurement was feasible. It was suitable for clinical use.