声辐射力脉冲成像技术术前评估胆道闭锁患儿肝硬化

目的 探讨声辐射力脉冲（ARFI）成像技术术前评估胆道闭锁患儿肝硬化的价值。方法 选取64例经胆道造影检查确诊的胆道闭锁患儿，于Kasai手术前3天内行ARFI检查，并在术中行肝组织活检，根据活检病理结果分为肝硬化组和非肝硬化组。于声触诊组织量化模式下测定肝脏剪切波速度（SWS）值，比较2组间SWS值的差异，并绘制ROC曲线，评价SWS值术前诊断胆道闭锁患儿肝硬化的价值。结果 64例胆道闭锁患儿中，肝硬化组8例，SWS值为（2.51±0.50） m/s；非肝硬化组56例，SWS值为（1.74±0.31） m/s，肝硬化组SWS值明显高于非肝硬化组（t=6.039，P<0.001）。ROC曲线分析显示ARFI技术诊断肝硬化的最佳临界值为2.16 m/s，曲线下面积为0.930（P<0.001），诊断敏感度、特异度分别为87.50%、92.86%。结论 ARFI成像技术在无创评价预测胆道闭锁患儿术前肝硬化中有一定的价值，可为临床选择治疗方案和判断疾病预后提供指导信息。

Acoustic radiation force impulse imaging in preoperative assessment of liver cirrhosis in infants with biliary atresia

Objective To investigate the diagnostic performance of acoustic radiation force impulse (ARFI) imaging in assessing liver cirrhosis preoperatively in infants with biliary atresia (BA). Methods A total of 64 consecutive infants with BA who underwent ARFI imaging in 3 days before Kasai surgery were recruited. Virtual Touch Quantification mode was used to measure shear wave speed (SWS). All infants with BA underwent liver biopsy during the surgery. The mean SWS of infants with and without liver cirrhosis were compared and analyzed. The diagnostic efficacy of SWS was observed using ROC curves. Results Liver cirrhosis was found in 8 of 64 infants. The mean SWS in infants with cirrhosis was significantly higher than that in infants without cirrhosis (2.51±0.50] m/s vs1.74±0.31] m/s, t=6.039, P<0.001). The cutoff value of SWS for predicting liver cirrhosis was 2.16 m/s, the area under ROC curve was 0.930 (P<0.001), and the diagnostc sensitivity and specificity was 87.50% and 92.86%, respectively. Conclusion ARFI imaging is helpful to prediction of liver cirrhosis in infants with BA preoperatively. It may be an effective method for clinical management and prognosis prediction in infants with BA.