声触诊弹性成像和声触诊弹性测量检测肝脾硬度重复性研究

Repeatability of sound touch elastography and sound touch quantification in measuring liver and spleen stiffness

目的探讨声触诊弹性成像(STE)和声触诊弹性测量(STQ)检测肝、脾硬度的可重复性。方法选取2017年10月至2018年6月在深圳市龙岗区第三人民医院行超声检查的245例患者。患者均签署知情同意书,符合医学伦理学规定。其中男157例,女88例;年龄18~80岁,中位年龄37岁。选用两位弹性成像初学者,其中1位无超声检查经验,1位有超声检查经验,分别行肝脏、脾脏STE和STQ检查。采用组内相关系数(ICC)评价检测可重复性,比较采用Z检验。结果无超声经验、有超声经验初学者操作50例肝脏STE和STQ检查后ICC分别为0.912、0.971和0.922、0.963,明显高于前50例的0.667、0.825和0.698、0.834(Z=3.558,4.543和3.582,3.803;P<0.05)。对于脾脏STE和STQ,亦有类似的结果(Z=3.582,3.803和2.055,2.162;P<0.05)。操作50例后肝脏STE和STQ两位操作间ICC为0.883和0.896;脾脏STE和STQ相应为0.593和0.517。结论对于无论有无超声检查经验的弹性成像初学者,操作50例后可重复性明显提高,肝脏检测可重复性非常好,而脾脏可重复性有待提高。

Objective To explore the repeatability of sound touch elastography(STE)and sound touch quantification(STQ)in detecting liver and spleen stiffness.Methods A total of 245 patients who underwent ultrasound examination in the Third People's Hospital of Shenzhen from October 2017 to June 2018 were recruited in this investigation.The informed consents of all patients were obtained and the local ethical committee approval was received.Among them,157 patients were male and 88 female.The patients were aged from 18 to 80 years with a median age was 37 years.Two beginners were selected to perform STE and STQ of the liver and spleen.One of them had no ultrasound examination experience and the other had ultrasound examination experience.The repeatability of STE and STQ were assessed by interclass correlation coefficient(ICC)and statistically compared by Z test.Results The ICC of liver STE after examining 50 patients by the beginner without ultrasound experience and the beginner with ultrasound experience were 0.912,0.971 and the STQ were 0.922,0.963,respectively,significantly higher than 0.667,0.825 and 0.698,0.834 in the first 50 patients(Z=3.558,4.543 and 3.582,3.803;P<0.05).Similar results were obtained for the STE and STQ of spleen(Z=3.582,3.803 and 2.055,2.162;P<0.05).The ICC of STE and STQ of liver between two beginners were 0.883 and 0.896 after examination of 50 cases,and were 0.593 and 0.517 for spleen STE and STQ.Conclusions For the beginners of elastography with or without ultrasound examination experience,the repeatability of STE and STQ can be significantly improved after 50 cases'examination.The repeatability of liver STE and STQ is extremely high,whereas that of STE and STQ of spleen should be improved.