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浙江大学学报（医学版）
浙江大学学报（医学版）  2016, Vol. 45 Issue (4): 416-421    DOI: 10.3785/j.issn.1008-9292.2016.07.13
原著     
瞬时弹性成像技术和声辐射力脉冲成像技术对慢性乙型肝炎肝纤维化的诊断价值
刘芳, 魏琳, 王珊珊, 黄斌
杭州市西溪医院特检科, 浙江 杭州 310023
Comparison of FibroTouch and acoustic radiation force impulse in diagnosis of liver fibrosis in patients with chronic hepatitis B
LIU Fang, WEI Lin, WANG Shanshan, HUANG Bin
Department of Ultrasound, Xixi Hospital of Hangzhou, Hangzhou 310023, China
全文: PDF(1012 KB)  
摘要: 

目的：比较超声弹性成像技术之瞬时弹性成像技术（FibroTouch）和声辐射力脉冲成像技术（ARFI）对慢性乙型肝炎肝纤维化的诊断价值。方法：收集2015年1月至11月在杭州市西溪医院就诊的慢性HBV感染者145例，以肝活检病理学检查结果为金标准，应用FibroTouch检测肝脏硬度（LSM值），应用ARFI检测肝脏剪切波速度（VTQ值）。两种检测值之间的相关性采用Spearman相关分析法，利用受试者工作特征（ROC）曲线分析两种检测方法对慢性乙型肝炎肝纤维化程度的诊断价值，并进行比较。结果：LSM与VTQ的相关系数为0.746（P<0.01），两者与肝活检组织病理学分期的相关系数分别为0.705和0.727（均P<0.01）。LSM值>8.4 kPa和VTQ值>1.49 m/s诊断S≥2期的ROC曲线下面积分别为0.857和0.836，两者差异无统计学意义（P>0.05）；LSM值>10.8 kPa和VTQ值>1.49 m/s诊断S≥3期的ROC曲线下面积分别为0.872和0.881，两者差异亦无统计学意义（P>0.05）；LSM值>12.3 kPa和VTQ值>1.81 m/s诊断S=4期的ROC曲线下面积分别为0.875和0.888，两者差异仍无统计学意义（P>0.05）。结论：FibroTouch和ARFI检测对无创定量评价慢性乙型肝炎肝纤维化程度的诊断价值一致，均可以用于临床评估慢性乙型肝炎患者肝纤维化程度。
关键词 ： 弹性成像技术,  肝炎,乙型,慢性/诊断,  肝硬化/诊断    
Abstract：

Objective: To compare transient elastorgaphy (FibroTouch) and acoustic radiation force impulse (ARFI) in diagnosis of liver fibrosis in patients with chronic hepatitis B. Methods: One hundred and forty five patients with chronic hepatitis B underwent FibroTouch and ARFI examinations in Xixi Hospital of Hangzhou from January to November 2015. The liver stiffness (LSM) was detected by FibroTouch and the liver shear wave velocity (VTQ) was detected by ARFI; liver biopsy was performed in all patients. With biopsy results as gold standards, the diagnostic values of FibroTouch and ARFI for liver fibrosis were analyzed with Spearman correlation analysis and receiver operating characteristic (ROC) curve. Results: The correlation coefficient of FibroTouch and ARFI was 0.746 (P<0.01). FibroTouch and ARFI were significantly correlated with pathological stage determined by liver biopsy(r=0.705 and 0.727, all P<0.01). When 8.4 kPa was taken as the cut-off value of LSM and 1.49 m/s was taken as the cut-off value of VTQ, the areas under ROC (AUCs) were 0.857 and 0.836 (P>0.05) in diagnosis of fibrosis S≥2 stage; when 10.8 kPa of LSM and 1.49 m/s of VTQ were used as cut-off values, the AUCs were 0.872 and 0.881 (P>0.05) in diagnosis of S≥3 stage; when 12.3 kPa of LSM and 1.81m/s of VTQ were used as cut-off values, the AUCs were 0.875 and 0.888 (P>0.05) in diagnosis of S=4 stage. Conclusion: Both FibroTouch and ARFI can be effectively used in evaluation of liver fibrosis in patients with chronic hepatitis B.
Key words： Elasticity imaging techniques    Hepatitis B, chronic/diagnosis    Liver cirrhosis/diagnosis
收稿日期: 2015-12-15
CLC:  R575.2  
基金资助:

浙江省自然科学基金（LY13H180015）
通讯作者: 黄斌(1973-),男,学士,副主任医师,主要从事腹部超声诊断及微创治疗;E-mail:Hb2k@163.com;http://orcid.org/0000-0001-5975-9386     E-mail: Hb2k@163.com
作者简介: 刘芳(1984-),女,硕士,主治医师,主要从事腹部超声诊断;E-mail:lyby555@163.com;http://orcid.org/0000-0001-8429-1770
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引用本文:

刘芳 等. 瞬时弹性成像技术和声辐射力脉冲成像技术对慢性乙型肝炎肝纤维化的诊断价值[J]. 浙江大学学报（医学版）, 2016, 45(4): 416-421.
LIU Fang, WEI Lin, WANG Shanshan, HUANG Bin. Comparison of FibroTouch and acoustic radiation force impulse in diagnosis of liver fibrosis in patients with chronic hepatitis B. Journal of ZheJiang University(Medical Science), 2016, 45(4): 416-421.

链接本文:

http://www.zjujournals.com/xueshu/med/CN/10.3785/j.issn.1008-9292.2016.07.13      或      http://www.zjujournals.com/xueshu/med/CN/Y2016/V45/I4/416

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