超声检查对肝脏硬化程度的诊断价值

Diagnosis of Liver Cirrhosis by Ultrasound Dimentional Image(U.D.I) Changes

目的:探讨超声检查对肝脏硬化的诊断价值。方法:对42例慢性肝炎、24例肝硬化患者在肝脏病理活检前或后2 d内行超声检查。依超声对肝脏表面、边缘、实质和肝内静脉四方面检查的综合积分评价肝脏硬化程度,并与病理分期作对比。结果:不同病理分期超声检查肝脏硬化综合积分值显著不同(F=130.25,P<0.01),病理分期越高,积分值也越大;肝脏硬化的超声检查综合积分值与病理分期呈显著正相关(r=0.989,P<0.01),根据经验公式Y=X/2-2,由已知的肝硬化综合积分值(X)便可得出病理分期(Y)的程度;曲线分析方法显示肝硬化综合积分值等于10为诊断肝硬化(早期肝硬化)的最佳临界值,其诊断的敏感性为87.5%,特异性为97.5%。结论:超声检查可较好的评价肝硬化的纤维化程度,为肝硬化的诊断提供了可靠的半定量指标。

Objective：To evaluate the value of ultrasound for diagnosing liver cirrhosis. Methods： Forty- two cases of chronic hepatitis and 24cases of cirrhosis in various histological liver fibrotic stages（2 cases of So, 20 cases of S1,17 cases of S2, 13 cases of S3 and 14 cases of S4）were included in this study. All ptients were examined by ultrasound in fasting state with a fibrotic scoring system, consisting of four items（liver surface, margin, parenchyma and intrahepatic vessels）, was used to evaluate the ultrasound findings and incontrast with fibrotic stages in each patients. Results. The results revealed that patients of various histological fibroic stage had significantly different total U. D. I scores（F = 130.25, P〈0.01 ）, the higher fibrotic histological stage; the more the dimentional fibrotic scare： the total liver fibrosis U. D. I scores had a significantly positive corr elation with the histological liver fibrotic stage（r = 0. 989, P〈0.01）;the stage of histological liver fibrosi s（Y）can be calculated by the total fibrotic U. D. I scores（X） according to the experiential formula： Y = X/2 - 2 ; receiver operating curves （ROC）showed that the best cut- off values for differentiating cirrhosis from chronic hepatitis with the sensitivity of 87.5 % and specificity of 97.5 %. Conclusion： These findings suggested that the combined fibrotic scores of ultrasound call provide a semiquantitative marker to evaluate liver fibrosis and differentiate cirrhosis from chronic hepatitis.