门静脉血流动力学改变与肝组织纤维化图像定量分析的相关性研究

Correlation between the portal venous hemodynamics and morphometric qu antitative analysis of liver fibrosis

目的探讨门静脉血流动力学改变与肝组织病理纤维化图像分析的相关性。方法用彩色多普勒超声测定106例慢性病毒性肝炎患者的门静脉主干内径、血流峰值速度、平均速度及血流量。所有患者均做肝穿刺活检。采用计算机图像分析系统对肝组织标本进行纤维化定量测定,同时根据常用的慢性肝炎分级分期标准对肝纤维化进行分期。结果肝纤维图像定量测定与纤维化病理分期有良好的相关性(r=0.690,P<0.01)。门静脉主干内径、血流峰值速度、平均速度与肝组织纤维化分期及纤维化图像定量分析结果均呈显著性相关(P<0.01),而门静脉血流量则与上述两者均无显著性相关(P>0.01)。结论多普勒超声探查门静脉血流动力学改变可反映肝纤维化的病理进程,对无创性评价慢性肝炎肝纤维化程度有重要意义。

Objective To evaluate the correlation between portal venous hemodynamics and morp hometric quantitative analysis of liver fibr osis.Methods The diameter of portal vein,the maxi mum and mean blood flow velocity of portal vein,the portal v enous blood flow were measured by col or Doppler system in 106patients wit h chronic viral hepatitis.Liver tissue samples were obtained by biopsy in all patients.Morphometric quantit ative analysis of liver fibrosis was perfo rmed with an automatic image-analysis system on the tissue samples.Addi tion-ally,the liver fibrosis was staged a ccording to the conventional protocol for the inflammation grading and f ibrosis staging in chronic hepatitis.Results The morphometric quantitative analysis of liver fibrosis significantl y corre-lated with the fibrosis stage(r=0.690,P<0.01).The diameter of portal vein,its max imum and mean blood flow velocity significantly correlated with both the quantitative analysis results and the fibrosis stage(P<0.01).However,the portal venous blood flo w had no significant correlation wit h both of the methods mentioned above(P>0.01).Conclusion Color Doppler evaluation of portal v enous hemodynamics can reflect the h istological changes of liver fibrosis and plays a n important role in the non-invasive assessment of liver fibrosis.[