声触诊组织量化技术——脾脏剪切波速度无创评估乙型肝炎肝纤维化程度的可行性分析

目的探讨声触诊组织量化(VTQ)技术测量脾脏剪切波速度无创评估乙型肝炎患者肝纤维化程度的可行性。方法应用VTQ技术对246例受试者测量脾脏剪切波速度(SWV),包括60例健康志愿者(归为S0期),53例慢性乙型肝炎患者(S1期12例,S2期19例,S3期20例,S4期2例)及133例临床诊断的乙型肝炎后肝硬化患者(归为S4期),将所得结果按纤维化分期进行分析。结果脾脏SWV与肝纤维化分期相关,相关系数为0.73(P<0.01);SWV在S0、S1、S2、S3期与S4期间差异均有统计学意义(P<0.01),其余各组间SWV差异无统计学意义(P>0.05);诊断S4期的受试者工作特征曲线下面积为0.95,诊断的临界值为2.78 m/s,灵敏性、特异性分别为0.86、0.94。结论基于VTQ技术的脾脏SWV在无创诊断乙型肝炎S4期有较好的应用前景。

Noninvasive assessment of liver fibrosis in chronic HBV-infected patients by spleen shear wave velocity based on virtual touch tissue quantification technique

Objective To explore the feasibility of spleen shear wave velocity （SWV） measured by virtual touch tissue quantification （VTQ） technique noninvasively evaluating liver fibrosis in chronic HBV-infected patients. Methods Spleen SWV were measured by VTQ technique in 246 subjects, including 60 healthy volunteers （SO stage）, 53 patients with chronic hepatitis B （12 cases of S1 stage, 19 cases of $2 stage, 20 cases of $3 stage and 2 cases of $4 stage） and 133 patients with hepatitis B cirrhosis（S4 stage）. The results were analyzed according to fibrosis classfication. Results Spleen SWV was correlated with fibrosis classfication （r=0.73, P 〈0.01 ）.There were significant differences between the stage of SO and S4, S1 and S4, S2 and S4, S3 and S4（ P 〈0.01 ）, while there were no significant differences between the stage of SO and S1, SO and S2, SO and S3, S1 and S2, S1 and S3, S2 and S3. The cut-offvalue for predicting cirrhosis （S4） was 2.78 m/s and the area under ROC curve was 0.95 with a sensitivity and specificity of 86% and 94%, respectively. Conclusion In chronic HBV-infected patients, spleen SWV based on VTQ technique has better application prospect on the noninvasive assessment of liver cirrhosis.