二维实时剪切波弹性成像诊断慢性肝病肝纤维化各分期的价值

目的 研究二维实时剪切波弹性成像诊断慢性肝病肝纤维化各分期的价值。 方法 选取87例慢性肝病肝纤维化患者作为病例组，以及同期86例健康体检者作为对照组，根据肝纤维化分期将病例组进行分组，2组均接受二维实时剪切波弹性成像检测，对比病例组各分期与对照组的肝脏硬度测定值（liver stiffness measurement，LSM），并比较病例组各组血清学指标，分析二维实时剪切波弹性成像检测相关性与诊断效能。 结果 S1、S2、S3、S4期LSM值均显著高于对照组，S4期显著高于S0、S1、S2、S3期，S3期显著高于S0、S1、S2期，S2显著高于S0、S1期，S1期显著高于S0期（P＜0.05）；经检查得出，S4期Ⅳ型胶原（Ⅳ collagen，Ⅳ-C）、层黏蛋白（laminin，LN）、血清透明质酸（hyaluronic acid，HA）显著高于S0、S1、S2、S3期，S3期Ⅳ-C、LN、HA显著高于S0、S1、S2期，S2期Ⅳ-C、LN、HA显著高于S0、S1期，S1期Ⅳ-C、LN、HA显著高于S0期（P＜0.05）；经过相关性分析得出，二维实时剪切波弹性成像与肝纤维化分期、Ⅳ-C、LN和HA呈正相关；根据病理结果为金标准，各个病理分期AUC结果分别为0.800、0.792、0.773、0.812，S1阈值为80.59，S2阈值为88.37，S3阈值为90.75，S4阈值为94.57。 结论 二维实时剪切波弹性成像能够有效判断慢性肝病患者肝纤维化程度，并且LSM与肝纤维化程度分期呈正相关。

The value of two-dimensional real-time shear wave elastography in the diagnosis of various stages of liver fibrosis in chronic liver disease

Objective To study the value of real-time two-dimensional shear wave elastography(2D-SWE) in the diagnosis of various stages of liver fibrosis in patients with chronic liver disease(CLD).Methods Eighty-seven CLD patients with liver fibrosis were selected as the pathological group, and 86 healthy physical examinees during the same period served as the control group. The pathological group was divided into groups according to the stage of liver fibrosis. Both groups received real-time 2D-SWE to compare the liver stiffness measurement(LSM) values of the pathological group and the control group as well as the serological indexes of the pathological group. The correlation between real-time 2D-SWE and the diagnostic efficiency was analyzed.Results The LSM values of S1, S2, S3, and S4 were significantly higher than those of the control group, and the value of S4 was significantly higher than that of S0, S1, S2, and S3; the value of S3 was significantly higher than that of S0, S1, and S2, and the value of S2 was significantly higher than that of S0, S1; the value of S1 was significantly higher than that of S0(P＜0.05). After detection, Ⅳ collagen(Ⅳ-C), laminin(LN), serum hyaluronic acid(HA) were significantly higher in S4 than in S0, S1, S2, and S3, and the indicators in S3 were significantly higher than those of S0, S1, and S2; the indicators in S2 were significantly higher than those of S0 and S1; the indicators in S1 were significantly higher than those of S0(P＜0.05). Correlation analysis showed that real-time 2D-SWE was positively correlated with fibrosis staging, Ⅳ-C and HA. According to the pathological results as the gold standard, the AUC results of each pathological stage were 0.800, 0.792, 0.773, and 0.812, respectively; the threshold of S1, S2,S3 and S4 was 80.59, 88.37, 90.75, and 94.57, respectively.Conclusion Real-time 2D-SWE can effectively determine the degree of liver fibrosis in patients with CLD, and there is a positive correlation between LSM and the stage of fibrosis.