声速匹配组织量化技术定量评价非酒精性脂肪性肝病的初步研究

目的 探讨声速匹配组织量化技术(SVQ)定量评价非酒精性脂肪性肝病(NAFLD)的可行性和临床应用价值。 方法 选取经肝穿刺或临床资料证实的非酒精性脂肪性肝病肝硬化患者22例为观察组，并选取正常健康人30例作为对照组，2组患者一般资料相比较差异无统计学意义，并分别采集2组患者临床相关资料，对2组患者进行声速匹配组织量化技术检测，采集声速匹配值(ZSI)，计算组织声速(SV)和组织感受性曲线(ROC)，平均采集5次，计算平均值，根据资料采集计算曲线下面积(AUC)和尤登指数，并确定临界值(cutoff)，判断该界值的敏感性、特异性、阳性似然比(LR+)、阴性似然比(LR-)。 结果 2组患者在年龄、身高、体重等一般资料方面比较，差异不具有统计学意义(P＞0.05)。观察组患者的BMI、ZSI和SV与对照组相比差异具有统计学意义(P＜0.01)。采用SVQ技术诊断NAFLD相关性肝硬化患者，其曲线下面积为0.921。以SV=1 587 m/s作为cutoff值，并计算灵敏度、特异度、阳性似然比、阴性似然比，数值分别为92.3%、80%、4.615、0.1。 结论 采用声速匹配组织量化技术评价非酒精性脂肪性肝病具有较高的诊断价值，并具有一定特异性，因此具有很好的临床应用价值，值得推广。 

A primary research of sound velocity tissue quantification in nonalcoholic fatty liver disease

Objective To evaluate the feasibility and clinical application of sound velocity matching tissue quantization(SVQ) quantitative evaluation of non-alcoholic fatty liver disease(NAFLD) feasibility and clinical value. Methods Nonalcoholic fatty liver cirrhosis in 22 patients were confirmed by liver biopsy or clinical data,30 healthy subjects were selected as the control group,two groups of patients with no significant difference between general information and two groups of patients were collected clinically relevant information on the two groups of patients to detect the speed of sound to match tissue to quantify the value of the acquisition to match the speed of sound(ZSI),calculate the speed of sound organization(SV) and tissue sensitivity curve(ROC),an average of five times the acquisition,calculate averages,calculate the area under the curve(AUC) and Youden index based on the information collected and determine the threshold(cutoff),determine the sensitivity of the critical value,specificity,positive likelihood ratio(LR+),negative likelihood ratio(LR-). Results The general information on age,height,weight and other data were no statistically significant differences in the two groups(P>0.05).Observation group were BMI,and SV are present ZSI significantly compared with the control group,the difference was statistically significant(P<0.01).Diagnosis of NAFLD using SVQ related cirrhosis,area under the curve of 0.921.In SV=1 587 m/s as a cutoff value,and calculate the sensitivity,specificity,positive likelihood ratio,negative likelihood ratio,the value was 92.3%,80%,4.615,0.1. Conclusion Matching tissue to quantify the speed of sound technical evaluation of non-alcoholic fatty liver disease has a high diagnostic value,and has certain specificity and good clinical value,worthy of promotion.