彩色多普勒超声半定量评分对早期乙型肝炎肝硬化的诊断价值

目的 研究彩色多普勒超声半定量评分诊断早期乙型肝炎肝硬化的临床价值。方法 选择2014年8月~2015年12月在我院诊治的肝硬化患者136例和慢性乙型肝炎患者364例,使用GE Logiq E8彩色多普勒超声诊断仪检测肝脏超声并进行半定量评分,常规进行肝活检。结果 肝硬化组门静脉流量、流速和内径分别为（86.3±7.5） ml/min、（3.8±0.1） cm/s、（11.5±1.4） mm,均明显高于慢性乙型肝炎组[分别为（62.3±6.4） ml/min、（3.1±0.1） cm/s、（8.7±1.6） mm,P<0.05];慢性乙型肝炎组肝静脉清晰度、肝表面被膜、胆囊壁、肝脏边缘形态、肝脏实质回声、肝内韧带、脾脏面积评分和总分分别为（1.1±0.3）分、（1.2±0.3）分、（1.1±0.2）分、（1.0±0.4）分、（1.1±0.5）分、（1.0±0.2）分、（1.4±0.4）分、（8.12±0.39）分,均明显低于肝硬化组[分别为（2.6±0.3）分、（4.1±1.2）分、（1.9±0.3）分、（1.9±1.0）分、（2.7±0.4）分、（1.4±0.5）分、（4.1±1.6）分、（15.1±1.1）分,P<0.05];彩色多普勒超声半定量评分对早期乙型肝炎肝硬化的诊断灵敏度为96.3%,特异度为92.31%,阳性预测值为82.4%,阴性预测值为98.5%。结论 彩色多普勒超声半定量评分对早期乙型肝炎肝硬化的诊断具有较高的灵敏度和特异度,可作为临床筛检早期乙型肝炎肝硬化的有效方法。

Diagnostic value of color Doppler ultrasound semi-quantitative scores in the diagnosis of patients with hepatitis B liver cirrhosis

Objective To investigate the diagnostic value of color Doppler ultrasound semi-quantitative score in the diagnosis of patients with viral hepatitis B liver cirrhosis. Methods 136 patients with hepatitis B liver cirrhosis and 364 with hepatitis B were recruited between August 2014 and December 2015 in this study. The portal vein flows,flow rates and internal diameters and semi-quantitative scores were conducted for the diagnostic validity of color Doppler ultrasound. Results The portal venous flow,velocity and diameter in cirrhotic group were （86.3±7.5） ml/min,（3.8±0.1） cm/s,（11.5±1.4） mm,significantly higher than those in patients with hepatitis B [（62.3±6.4） ml/min,（3.1±0.1） cm/s,（8.7±1.6） mm,P<0.05];the distinct of hepatic vein,hepatic surface,gallbladder,liver morphological edge,liver parenchyma,intrahepatic ligament,and the size of spleen and the total scores in patients with hepatitis B were （1.1±0.3）,（1.2±0.3）,（1.1±0.2）,（1.0±0.4）,（1.1±0.5）,（1.0±0.2）,（1.4±0.4）,（8.1±0.3）,significantly lower than in cirrhotic group [（2.6±0.3）,（4.1±1.2）,（1.9±0.3）,（1.9±1.0）,（2.7±0.4）,（1.4±0.5）,（4.1±1.6）,（15.1±1.1）,P<0.05];the sensitivity by color Doppler ultrasonic semi quantitative score in diagnosis of early hepatitis B liver cirrhosis was 96.3%,the specificity was 92.3%,the positive predictive value was 82.4%,and the negative predictive value was 98.5%. Conclusion Color Doppler ultrasound semi-quantitative score has high specificity and sensitivity in the diagnosis of early hepatitis B liver cirrhosis, which might be used as an effective method for clinical screening in patients with chronic hepatitis B.