实时剪切波弹性成像测量脾脏硬度评价肝硬化门静脉高压

目的 探讨实时剪切波弹性成像（SWE）测量脾脏弹性对肝硬化门静脉高压患者的诊断价值。方法 收集64例肝硬化门静脉高压患者（PH组）和62例无门静脉高压的肝硬化患者（对照组），分别测量并比较两组患者的脾脏弹性、脾脏厚度及脾脏长径，并采用DeLong检验比较SWE脾脏弹性、脾脏厚度及脾脏长径诊断肝硬化门静脉高压的ROC曲线下面积，确定脾脏弹性诊断肝硬化门静脉高压的最佳临界值，并计算相应的敏感度和特异度。结果 PH组与对照组脾脏弹性、脾脏厚度及脾脏长径差异均有统计学意义（P均<0.001）。SWE脾脏弹性、脾脏厚度及脾脏长径诊断肝硬化门静脉高压的ROC曲线下面积分别为0.979、0.917和0.865，两两比较差异均有统计学意义（P均<0.05）。脾脏弹性诊断肝硬化门静脉高压的最佳临界值为19.98 kPa，敏感度和特异度分别为95.78%和94.27%。结论 SWE测量脾脏硬度诊断肝硬化门静脉高压的效能高于测量脾脏厚度和脾脏长度，对肝硬化门静脉高压有较高诊断价值。

Real-time shear wave elastography measurement of splenic elasticity in evaluation of liver cirrhosis with portal hypertension

Objective To investigate the diagnostic value of splenic elasticity measured with real-time shear wave elastography (SWE) in liver cirrhosis patients with portal hypertension. Methods Totally 64 cirrhotic patients with portal hypertension (PH group) and 62 liver cirrhosis patients without portal hypertension (control group) were enrolled. The elasticity, the thickness and the length of the spleen of both groups were compared. The areas under the ROC curve (AUC) of the SWE elasticity, the thickness and the length of the spleen were compared with a DeLong test. The optimal cutoff value of SWE elasticity was obtained, and the sensitivity and specificity were calculated, respectively. Results The differences of the SWE elasticity, the thickness and the length of the spleen between the two groups were statistically significant (all P<0.001). AUC of SWE elasticity, thickness and length of the spleen was 0.979 (95%CI), 0.917 (95%CI and 0.865 (95%CI), respectively. The differences between each two parameters were statistically significant (all P<0.05). The optimal cutoff value of the spleen SWE elasticity was 19.98 kPa, the sensitivity and the specificity was 95.78% and 94.27%, respectively. Conclusion The diagnostic efficacy of spleen SWE elasticity was higher than that of spleen thickness and spleen length, therefore having better diagnostic value for liver cirrhosis patients with portal hypertension.