FibroTouch和声触诊组织量化成像参数评估血吸虫病性肝病患者肝纤维化临床研究

FibroTouch and virtual touch tissue quantification parameters in evaluating liver fibrosis in patients with schistosomiasis-induced liver disease

目的探讨FibroTouch和超声声触诊组织量化成像(VTQ)参数评估血吸虫病性肝病(SILD)患者肝纤维化的临床价值。方法2019年2月~2023年2月我院诊治的肝血吸虫病患者58例,均接受病原学和护肝治疗。在治愈后使用FibroTouch行肝脏硬度检测(LSM),使用VTQ检测肝剪切波速度(SWV)。所有患者接受肝活检评估肝纤维化分期,应用ROC分析FibroTouch和VTQ检查参数诊断肝纤维化的效能。结果在58例SILD患者中,肝组织学检查发现S0期7例(12.1%)、S1期15例(25.9%)、S2期16例(27.6%)、S3期12例(20.7%)和S4期8例(13.8%);S4期患者LSM和SWV分别为(17.4±2.0)kPa和(1.9±0.2)m/s,均显著大于S3期【分别为(15.7±3.4)kPa和(1.7±0.3)m/s,P<0.05】或S2期【分别为(12.4±2.8)kPa和(1.5±0.4)m/s,P<0.05】或S1期【分别为(8.7±2.0)kPa和(1.3±0.3)m/s,P<0.05】或S0期【分别为(5.8±0.9)kPa和(1.1±0.2)m/s,P<0.05】;经ROC分析发现,分别以LSM=12.8 kPa和SWV=1.5 m/s为截断点,两者联合诊断显著性肝纤维化的曲线下面积(AUC)为0.937,其诊断的敏感度为87.5%,特异度为90.0%,具有较高的诊断效能。结论应用FibroTouch参数LSM和VTQ参数SWV评估SILD患者显著性肝纤维化分期具有一定的临床价值,值得进一步研究。

Objective The aim of this study was to explore clinical efficacy ofFibroTouchand virtual touch tissue quantification(VTQ)parameters in evaluating liver fibrosis in patients with schistosomiasis-induced liver disease(SILD).Methods 58 patients withSILDwere enrolled in our hospital between February 2019 and February 2023,and they all received etiological,liver-protecting and symptomatic supporting treatment.After recovery,FibroTouch was used to detect liver stiffness measurement(LSM),and VTQ was applied to detect liver shear wave velocity(SWV).Liver biopsy was performed to evaluate liver fibrosis staging,and receiver-operating characteristic curve(ROC)was adopted to analyze diagnostic performance of FibroTouch and VTQ parameters in predicting significant liver fibrosis(SLF).Results Of 58 patients with SILD,liver histo-pathological examination showed liver fibrosis S0 stage in 7 cases(12.1%),S1 stage in 15 cases(25.9%),S2 stage in 16 cases(27.6%),S3 stage in 12 cases(20.7%)and S4 stage in 8 cases(13.8%);LSM and SWV in patients with S4 liver fibrosis were(17.4±2.0)kPa and(1.9±0.2)m/s,both significantly greater than[(15.7±3.4)kPa and(1.7±0.3)m/s,P<0.05]in patients with S3 or[(12.4±2.8)kPa and(1.5±0.4)m/s,P<0.05]in those with S2 or[(8.7±2.0)kPa and(1.3±0.3)m/s,P<0.05]in S1 or[(5.8±0.9)kPa and(1.1±0.2)m/s,P<0.05]in S0;ROC analysis showed that AUCwas 0.937,with sensitivity of 87.5%and specificity of 90.0%,when LSM and SWV combination(with 12.8 kPa and 1.5 m/s as cut-off-value,respectivley)in predicting SLF in patients with SILD.Conclusion Combination of LSM and SWV in predicting SLF in patients with SILD really has certain clinical diagnostic efficacy,which might help guide clinicians to make intervention early.