超声纹理分析方法诊断乙型肝炎早期肝硬化的价值

目的探讨超声定量诊断乙型肝炎早期肝硬化的临床价值。方法采集186例有肝穿刺病理结果的乙型肝炎患者的标准声像图,提取声像图纹理的14个灰度共生矩阵（GLCM）参数,与病理诊断比较。结果其中10个参数在无肝硬化和早期肝硬化组间差异有统计学意义（P〈0.05）。利用超声纹理参数建立的判别分析模型诊断无肝硬化和早期肝硬化的正确率分别为87.1%和93.5%,88.2%病例能够被准确分组,诊断早期肝硬化的敏感性、特异性、假阴性率、假阳性率、阳性预测值、阴性预测值、阳性似然比、阴性似然比及受试者工作特征曲线下面积（AUROC）分别为93.5%、87.1%、6.5%、12.9%、59.2%、98.5%、7.25、0.07及0.903。结论无创性超声纹理分析能够较准确地诊断人类乙型肝炎早期肝硬化。

The value of ultrasonic texture analysis in early diagnosis of hepatitis B virus related cirrhosis

Objective To evaluate the value of ultrasonic texture analysis in early diagnosis of liver cirrhosis in patients with hepatitis B virus（HBV）.Methods Ultrasonography was performed in 186 patients with chronic HBV infection who had undergane liver biopsies and serum tests.14 texture parameters of gray level co-occurrence matrix were obtained from the standard sonograms.Liver fibrosis was staged from S0 to S4 histopathologically.Patients of S4 were recognized as early cirrhosis and others as no cirrhosis.Results ANOVA showed that the differences in 10 of 14 parameters and groups were significant（P0.05）.Based on them,discriminant analysis model was established to identify early cirrhosis from chronic HBV infection.The accuracy rates were 87.1% and 93.5% respectively,88.2% of cross-validated cases were appropriately classified.The sensitivity,specificity,false negative rate,false positive rate,positive predictive value,negative predictive value,positive likelihood rate,negative likelihood rate and area under receiver operating characteristic curve of the model for early detection of cirrhosis was 93.5%,87.1%,6.5%,12.9%,59.2%,98.5%,7.25,0.07 and 0.903（95% CI 0.844-0.962） respectively.Conclusion As a noninvasive method,ultrasonic texture analysis could be used to early predict HBV related cirrhosis with a relative high accuracy.