乙型肝炎后肝纤维化的超声与病理对比研究

Comparative study on hepatitis B-related liver fibrosis between ultrasonograph and histology

目的：探讨超声对乙型肝炎后肝纤维化无刨性评估的可行性。方法：对30例慢性乙型肝炎患者进行常规彩色多普勒超声检查，重点观察肝包膜光滑度、肝实质回声、胆囊壁厚度、脾脏大小、门脉主干血流量（V1）、脾静脉与肠系膜上静脉血流量之和（V2）及V2／V1等指标。患者同时进行肝穿活检，病理根据纤维化程度分为S0～S4五期。结果：肝包膜光滑度、肝实质回声类型与纤维化程度有良好的相关性，V1、V2与纤维化分期无关，而V2／V1与纤维化程度有一定相关性，但各期之间存在较大重叠。结论：超声作为简便易行的无创性检查手段，对评价肝纤维化程度有明确意叉，但目前仍不可替代穿刺活检。

Objective To determine the feasibility of ultrasound techniques in evaluating hepatitis B-related liver fibrosis. Methods Color Doppler sonographic examinations were performed in 30 patients with chronic B-related hepatitis to observe liver surface and hepatic parenchymal echo pattern carefully, measured gallbladder wall thickness, the size of spleen, the flow of main portal vein（V1）, the summation of splenic vein＇s flow and superior mesenteric vein＇s flow （V2）, then calculate the ratio of V2 to V1. The patients undertaken needle biopsy as well,histologically their liver fibrosis were graded as SO to S4. Results Liver surface and hepatic parenchymal echo pattern have correlation with hepatic fibrosis stage. It seemed that V1 and V2 have nothing to do with hepatic fibrosis stage, however the ratio of V2 to V1 has partial correlation with it, although there is some overlap between these groups. Conclusion As an noninvasive method, ultrasound examination can be used to evaluate fibrosis degrees in chronic B-related hepatitis, but now it can＇t replace biopsy thoroughly.