声触诊组织定量技术对慢性乙型肝炎肝纤维化程度的诊断价值

目的：探讨声触诊组织定量技术对慢性乙型肝炎肝纤维化程度的诊断价值。方法：使用ACUSON S2000型彩色多谱勒超声诊断仪,测量96例慢性乙型肝炎患者和30名正常对照组的肝脏剪切波速。根据肝穿刺活检病理学肝纤维化分期对96例患者进行分组,运用受试者工作特征曲线初步划分不同肝纤维化程度剪切波速范围,并将剪切波速与病理结果进行相关性分析。结果：除对照组与肝纤维化S0期和S1期以及S0期与S1期之间的剪切波速差异无统计学意义（P〉0.05）外,其余各组间剪切波速差异均有统计学意义（P〈0.01）;以1.38 m/s、1.74 m/s、2.19 m/s、2.53 m/s作为诊断S≥1,S≥2,S≥3,S=4的受试者工作特征曲线下面积分别为0.808、0.872、0.889、0.861,对应的诊断敏感性分别为75.8%、80.5%、79.2%、78.6%,特异性分别为77.3%、83.4%、84.1%、79.5%。肝脏剪切波速与纤维化分期、炎症分级间均呈正相关关系（P〈0.05）。结论：声触诊组织定量技术是无创性评价慢性乙型肝炎肝纤维化分期诊断的新方法。

The diagnostic value of virtual touch quantification technology for liver fibrosis grades induced by chronic hepatisis B

Objective： To study the diagnostic value of virtual touch quantification technology in liver fibrosis grades induced by chronic hepatisis B. Methods： The study subjects were performed the measurements of liver shear wave velocity by using a ultrasonic instrument named ACUSON S2000,and were composed with 30 normal control and 96 patients with chronic hepatitis B. The cutoff values of shear wave velocity of different liver fibrosis stages were detected and the correlations between shear wave velocity and pathological grades of the liver were analyzed. Results： The results showed that except for the shear wave velocity values among the control group and liver fibrosis stage S0 and stage S1 groups,and between liver fibrosis stage S0 and stage S1 groups,there were significant differences about the shear wave velocity values between other groups（ P〈 0. 01）. Using the cutoff values of 1. 38m /s,1. 74m /s,2. 19 m /s and 2. 53m /s for diagnosis of S ≥ 1,S ≥ 2,S ≥ 3 and S = 4,the corresponding areas under receiver operating characteristic were 0. 808,0. 8723,0. 889 and 0. 861 respectively,and the corresponding sensibilities were 75. 8%,80. 5%,79. 2%,78. 6%,the specificities were 77. 3%,83. 4%,84. 1%,79. 5% respectively. The significant positive correlations were found between the shear wave velocity values and the grade of fibrosis and inflammation（ P〈0. 05）. Conclusions： Virtual tuoch quantification technology is a new non-invasive method to evaluate liver fibrosis grades induced by chronic hepatisis B.