超声造影时间强度曲线无创性定量分析代偿期肝硬化的诊断效能

目的 分析超声造影时间强度曲线对代偿期肝硬化的诊断效能。 方法 收集66例乙型肝炎患者,所有患者均进行超声造影并取得病理学检查结果。根据Metavir评分标准将所有患者分为3组:正常或轻微纤维化组(组1,n=35),中、重度纤维化组(组2,n=24),肝硬化组(组3,n=7)。比较各组患者超声造影参数,如肝动脉时间-强度曲线斜率梯度(HASG)、门静脉时间-强度曲线斜率梯度(PVSG)、肝静脉时间-强度曲线斜率梯度(HVSG)、肝静脉到达时间(HVAT)、HV-HA渡越时间(HA-HVTT)及HV-PV渡越时间(PV-HVTT)的差异,分析各超声造影参数对代偿期肝硬化的诊断效能。 结果 PVSG、肝静脉到达时间、HV-HA渡越时间及HV-PV渡越时间的比较,组1大于组2(30.16±2.77 vs 25.00±2.65,30.52±2.74s vs 27.33±1.96s,10.6±0.46s vs 7.65±0.57s,6.68±0.69s vs 3.02±0.27s)、组3(30.16±2.77 vs 20.27±2.01,30.52±2.74s vs 25.42±1.83s,10.6±0.46s vs 5.75±0.36s,6.68±0.69s vs 1.98±0.42s),差异有统计学意义(P<0.05),组2与组3之间比较,差异无统计学意义(P>0.05)。PVSG、HVAT、HA-HVTT及PV-HVTT对肝硬化均有较好的诊断效能,其曲线下面积分别为0.821、0.777、0.902、0.940,敏感度分别为91.7%、70.8%、87.5%、75.0%,特异性分别为85.7%、85.7%、85.7%、71.4%。 结论 超声造影时间强度曲线参数,特别是门静脉时间强度曲线斜率梯度,对代偿期肝硬化有较高的诊断效能。

Diagnostic Efficiency of the Time-intensity Curve in Contrast-enhanced Ultrasonography in Patients with Compensated Cirrhosis

Objective To investigate the diagnostic efficiency of the time-intensity curve in contrast-enhanced ultrasonography in patients with compensated cirrhosis. Methods Sixty-six patients with hepatitis B were divided into 3 groups according to the Metavir score: F0/1 group(Group 1, n=35), F2/3 group (Group 2, n=24) and F4 group (Group 3, n=7). The parameters of contrast-enhanced ultrasonography, such as the slope gradients (SG) of time-intensity curves of the hepatic artery(HASG),hepatic vein(HVSG),the portal vein(PVSG), hepatic vein arrivaltime(HVAT), HV-HA interval time(HA-HVTT) and HV-PV interval time(PV-HVTT) were compared among three groups. Diagnostic efficiency of these parameters in patients with compensated cirrhosis was analyzed. Results The PVSG,HVAT,HV-HATT and HV-PVTT in Group 1 was significantly higher than that in Group 2(30.16±2.77 vs 25.00±2.65,30.52±2.74s vs 27.33±1.96s,10.6±0.46s vs 7.65±0.57s,6.68±0.69s vs 3.02±0.27s). The PVSG,HVAT,HV-HATT and HV-PVTT in Group 1 was significantly higher than that in Group 3(30.16±2.77 vs 20.27±2.01,30.52±2.74s vs 25.42±1.83s,10.6±0.46s vs 5.75±0.36s,6.68±0.69s vs 1.98±0.42s), The difference was statistically significant between the two groups (P<0.05). There were no statistical differences in the PVSG,HVAT,HV-HATT and HV-PVTT between the Group 2 and Group 3 (P>0.05).The area under the ROC curve for the PVSG, HVAT, HV-HATT and HV-PVTT were 0.821,0.777,0.902 and 0.940, respectively. The sensitivity was 91.7%,70.8%,87.5% and 75.0%, respectively. The specificity was 85.7%,85.7%,85.7% and 71.4%, respectively. Conclusion The parameters of the time-intensity curve in contrast-enhanced ultrasonography, particularly PVSG, demonstrate high accuracy in diagnosing cirrhosis.