声触诊组织量化技术无创评价慢性肝病的初步研究

目的探讨声触诊组织量化(VTQ)技术无创评价肝纤维化程度的临床应用价值。方法 62例肝纤维化患者(S1~S3期组)、36例肝硬化患者(S4期组)及50例健康志愿者(对照组),应用VTQ技术定量检测肝实质剪切波速度。结果对照组、S1~S3期组及S4期组患者剪切波速度分别为(1.11±0.19)m/s、(1.62±0.41)m/s及(2.48±0.53)m/s,三者比较差异有统计学意义(P﹤0.05)。S1~S3期组ROC曲线下面积为0.801,S4期组ROC曲线下面积为0.956。剪切波速度以1.30m/s为界值,诊断S1~S3期的敏感性为81%,特异性为79%;以1.81m/s为界值,诊断S4期的敏感性为92%,特异性为85%。结论 VTQ可无创测量肝实质剪切波速度,客观反映肝组织的弹性模量,有望为定量评估肝纤维化和肝硬化提供一种客观、准确的新方法。

Primary study of virtual touch tissues quantification technique for noninvasively assessing chronic liver disease

Objective To evaluate clinical value of virtual touch tissues quantification （VTQ） for the noninvasive assessment of liver fibosis.Methods Sixtytwo cases of liver fibosis （S1-S3） and 36 cases of liver cirrhosis （ $4 ）were involved in this study and 50 healthy people were used as the control group.Shear wave velocity was measured in liver parenchyma by virtual touch tissues quantification technique.Results The average velocity of liver shear wave was respectively （ 1.62±0.41 ）m/s in patients with liver fibosis, （ 2.48 ± 0.53 ） m/s in patients with liver cirrhosis and （ 1.11 ± 0.19 ） m/s in the healthy control group. Significant difference was found in liver shear wave velocity among the three groups （P 〈 0.05 ）.The areas under ROC curves were 0.801 for S1 S3 and 0.956 for S4 in our study.The optimal cutoff value was 1.30 m/s for S1 -S3 with a sensitivity of 81% and specificity of 79% and 1.81 m/s for S4 with a sensitivity of 92% and specificity of 85%.Conclusion This study indicated that VTQ technique could measure the velocity of shear wave in liver tissue non-invasively and would provide a new feasible and accurate way to quantitatively evaluate liver cirrhosis and liver fibosis.