肝肾灰阶比值分析肝纤维化严重程度的临床价值

Hepatic and kidney gray-scale ratio： a new index for quantifying hepatic fibrosis degree

目的探讨肝实质与肾皮质灰阶比值评定肝纤维化严重程度的临床应用价值。方法常规腹部超声检查60例肝纤维化患者及40例健康志愿者；将超声仪器条件设置一致后，选取肝肾切面冻结后，将图像存储于超声图文工作站硬盘，图像导人计算机后利用Photoshop软件定制直方图取样范围，测量肝近程、中程、远程灰阶值及右肾皮质灰阶值，将肝实质与自身肾皮质的灰阶比值作为诊断肝纤维化的新指标，与病理结果进行统计学分析。结果随肝纤维化程度加重，肝回声增强，而其自身肾皮质回声无明显变化，肝肾灰阶比值相应增加，与预测结果一致；肝纤维化组与对照组间肝肾灰阶比值差异有统计学意义（P〈0．01）。结论超声测定的肝肾灰阶比值较少受患者个体透声状况等因素影响，可作为临床无创诊断肝纤维化、评价肝纤维化程度及观察其疗韩的新指标。

Objective To investigate hepatic parenchyma and kidney cortex＇s gray-scale ratio as a new index in evaluating hepatic fibrosis degree. Methods Sixty patients with hepatic fibrosis verified by liver biopsy and 40 normal individuals used as controls were scanned with Acuson Sequoia 512 with the same set-up of all the parameters. The hepatic-right kidney section was selected for offline analysis. The gray-scale value of near-area hepatic, mid-area hepatic, far-area hepatic parenchyma and right kidney cortex were measured by histogram of Photoshop software. The gray-scale ratio of hepatic parenchyma to kidney cortex was calculated and compared with the hepatic firbrosis degree. Results With development of hepatic fibrosis, the ratio of hepatic and kidney gray-scale value was increased. The results between control and experimental groups were significant （P〈0.01）. Conclusions Hepatic and kidney gray-scale ratio obtained from gray scale ultrasound was rarely affected by individual conditions of acoustic windows. It could be used as a new index for diagnosing of hepatic fibrosis and evaluating its therapeutic effects.