实时组织超声弹性成像技术评价慢性乙型肝炎患者肝脏纤维化程度的价值

目的探讨实时组织超声弹性成像(RTE)技术评价慢性乙型肝炎患者肝纤维化程度的价值。方法15例健康志愿者(对照组)及30例慢性乙型肝炎患者(病例组)接受RTE检查及APRI值测量,由组织弥散定量分析软件得到弹性图像的定量参数,其结果与肝活检病理的纤维化分期相对照。结果弹性图像的定量参数,包括应变均值(MEAN)、标准差(SD)、蓝色领域%(%ARE-A)、复杂度(COMP)、峰度(KURT)、偏度(SKEW)、对比度(CONT)、均等性(ENT)、复杂度(IDM)、一致性(ASM)、相关性(CORR)、肝纤维化指数(LF index)及APRI值,各纤维化分期之间进行方差分析均有统计学差异(P<0.01或P<0.05),以LF index及APRI值判断S≥S4期绘制ROC曲线,曲线下面积分别为0.905、0.857。结论 RTE技术是一种有价值的评估肝纤维化分期的新方法。

Significance of real-time tissue elastography in evaluating liver fibrosis in patients with chronic hepatitis B

Objective To investigate the value of real-time tissue elastography(RTE) in evaluating liver fibrosis in patients with chronic hepatitis B. Methods RTE was performed in 30 patients with chronic hepatitis B and 15 healthy volunteers.The quantitive parameters of elastography imaging were obtained by the tissue dispersion quantitative analysis software.The results were compared among different stages of S1,S2,S3 and S4 liver fibrosis reported by biopsy one week after RTE. Results Of 12 quantitive parameters,the average relative strain value(MEAN) was decreased as the stage of liver bibrosis was increased(P<0.01),the rest parameters were all increased as the stage of liver bibrosis was increased(P<0.01 or P<0.05),which included standard deviation of relative strain value(SD),area ratio of low-strain region(%AREA),complexity(COMP),kurtosis(KURT),skewness(SKEW),contrast(CONT),entropy(ENT),inverse different moment(IDM),angular second moment(ASM),correlation(CORR) and liver fibrosis index(LF index).The area under ROC curve(AUC) made by LF index and APRI of LF index and APRI were 0.905,0.857,respectively. Conclusion RTE is a new and valuable technology for the assessment of liver fibrosis in patients with chronic hepatitis B.