声触诊组织量化技术检测肝纤维化的可行性分析

目的 研究声触诊组织量化(virtual touch tissues quantification,VTQ)技术检测肝纤维化的可行性及适宜的检测部位.方法 应用Acuson S2000超声仪对533例"健康"人群、慢性乙肝患者及脂肪肝患者进行肝硬度测量.对每位受检者的肝右叶浅部、肝右叶深部、肝左叶浅部及肝左叶深部4个位置分别测量5次.用组内相关系数(intraclass correlation coefficient,ICC)评价分析不同人群不同部位检测结果的可重复性.结果 肝左右叶不同部位的检测成功率均较高,尤其是肝右叶的肝实质;成功率最低者为肝左叶深部.不同疾病状态下不同部位(除脂肪肝组左叶深部外)ICC均>0.75.在肝右叶深部,对照组与慢性乙肝组、慢性乙肝组与脂肪肝组之间VTQ值差异具有极显著统计学意义(P=0.000).结论 VTQ技术检测肝纤维化程度稳定性良好,肝右叶更适合作为检测VTQ的测量部位,VTQ技术可以无创性评估肝硬度.

Feasibility of virtual touch tissues quantification technique in the assessment of liver fibrosis

Objective To evaluate the feasibility of virtual touch tissues quantification (VTQ) technique in the assessment of liver fibrosis and to find the suitable measuring position of VTQ. Methods Liver stiffness was measured with Acuson S2000 ultrasound system in totally 533 subjects including healthy people ( n = 302), patients with hepatitis B virus(HBV) ( n = 191) and patients with fatty liver ( n =40). Each subject received VTQ measurements in four parts (superficial and deep parts of right lobe, and superficial and deep parts of left lobe) and every part was measured five times to get five values. The reproducibility of different part of VTQ was analyzed with intraclass correlation coefficient (ICC). Results The achievement rate was high in both right and left lobes,especially in right lobe. The lowest rate was from the deep part of left lobe. Except deep part of left hepatic lobe in fatty liver,all parts of liver in all groups of patients were with ICC higher than 0. 75. In deep part of right lobe, VTQ values were (1.12 ± 0. 19)m/s in control group subjects, (1.83 ± 0. 62)m/s in patients with hepatitis B virus and (1.05 ± 0. 25)m/s in patients with fatty liver. There was significant difference of VTQ value between control group and patients with HBV ( P = 0.000), also between patients with HBV and patients with fatty liver ( P = 0.000). Conclusions It is stable to measure liver stiffness with VTQ technique, which is a new method to evaluate liver stiffness noninvasively. Right hepatic lobe is the most suitable position to be measured.