声触诊组织量化技术评估慢性肝纤维化的应用研究

Application of virtual touch tissue quantification technique in the assessment of liver fibrosis

目的探讨采用声触诊组织量化(VTQ)技术评估肝实质纤维化的应用价值。方法应用VTQ技术对36例慢性乙型肝炎患者和55例健康志愿者的肝实质进行检测,用9L4线阵超声探头测定肝实质的剪切波速度(SWV)。结果健康对照组和慢性乙型肝炎组缺失值出现率分别为26.55%和51.11%,差异有统计学意义(P<0.01);健康对照组和慢性乙型肝炎组SWV测值分别为(1.35±0.39)m/s和(2.27±0.76)m/s,健康对照组小于慢性乙型肝炎组(P<0.05)。通过ROC曲线确定变量的临界值为1.79 m/s,曲线下面积为0.94(P<0.05),对应的敏感度、特异度、阳性似然比、阴性似然比和Youden指数分别为86.89%、91.11%、9.77、0.14和0.78。结论 VTQ可快速无创测量肝实质剪切波速度,可客观反映肝组织的弹性模量。

Objective To explore the values of virtual touch tissue quantification (VTQ)in the assessment of liver fibrosis.Methods 36 patients with chronic hepatitis B (CHB group)and 55 healthy volunteers (control group)were recruited.The shear wave velocity (SWV)of the right hepatic lobe was measured by linear (9L4)array transducer.Results There were significant difference in the occurrence rate of missing data using the 9L4 transducer between control group and CHB groups,which was 26.55%and 51.11%,respectively (P<0.01).The SWV of con-trol group and CHBs were(1.35 ±0.39)m/s and (2.27 ±0.76)m/s (P<0.05).The cut-off level was 1.79 m/s and area under the receiver-operating characteristic curve (AUROC)was 0.95 according to the ROC curves,and the corresponding sensitivity,specificity,positive likelihood ratio,negative likelihood ratio,and Youden''s index were 86. 89%,91.11%,9.77,0.14,and 0.78,respectively.Conclusion VTQ is a reliable,noninvasive and rapid method for estimating the value of SWV,which may reflect the elastic modulus of liver tissues objectively.