声触诊组织量化技术诊断肝纤维化

目的探讨通过超声弹性成像声触诊组织量化（VTQ）技术判断不同分期肝纤维化的价值。方法收集311例慢性乙肝致肝纤维化患者,根据肝纤维化病理分期,分为A组（S1期,161例）、B组（S2期,66例）、C组（S3期,39例）、D组（S4期,45例）;另选100名健康志愿者作为对照组。回顾性分析各组的肝脏超声弹性成像VTQ值。结果 A、B、C、D组及对照组VTQ值分别为（1.41±0.24）m/s、（1.66±0.42）m/s、（2.01±0.60）m/s、（2.44±0.81）m/s、（1.06±0.17）m/s,A、B、C、D组与对照组间差异均有统计学意义（P均〈0.01）,A、B、C、D组间两两比较差异有统计学意义（P均〈0.01）。当VTQ阈值为1.20、1.51、1.60、1.93m/s时,诊断S1期、S2期、S3期及S4期肝纤维化的敏感度、特异度及准确率分别为88.40%、84.02%、93.30%,73.32%、73.91%、79.54%,82.12%、73.11%、84.58%和73.29%、85.33%、85.41%。结论肝脏超声弹性成像VTQ值为判断肝纤维化分期较为准确的指标。

Virtual touch quantification technique in diagnosis of hepatic fibrosis

Objective To observe the diagnostic value of elastosonography in grading hepatic fibrosis with virtual touch quantification(VTQ) technique.Methods Totally 311 patients of liver fibrosis caused by chronic hepatitis B were enrolled and divided into 4 groups according to the classification of liver fibrosis: Group A(S1 stage,n=161),B(S2 stage,n=66),C(S3 stage,n=39) and D(S4 stage n=45).Meanwhile,there were 100 healthy volunteers in control group.A retrospective analysis of VTQ value in each group was performed.Results VTQ value in group A,B,C,D and control group was(1.41±0.24)m/s,(1.66±0.42)m/s,(2.01±0.60)m/s,(2.44±0.81)m/s and(1.06±0.17)m/s,respectively.And VTQ value in group A,B,C and D was separately higher than that in control group(all P<0.01).There were statistical differences of VTQ value among group A,B,C and D by paired comparison(all P<0.01).Taking 1.20 m/s,1.51 m/s,1.60 m/s and 1.93 m/s as VTQ thresholds of various stages,the sensitivity,specificity and accuracy in grading S1,S2,S3 and S4 stage hepatic fibrosis was 88.40%,84.02%,93.30%;73.32%,73.91%,79.54%;82.12%,73.11%,84.58%;73.29%,85.33% and 85.41%.Conclusion VTQ value is an accurate index in judging different stages of liver fibrosis.