声辐射力脉冲成像技术在评价肝纤维化程度的临床价值

Clinic Value of Evaluation of Hepatic Fibrosis Degree with Acoustic Radiation Force Impulse(ARFI)

目的分析声辐射力脉冲成像技术(acoustic radiation force impulse,ARFI)在评价慢性肝病患者肝纤维化程度中的临床价值。方法利用声辐射力脉冲成像技术对61例慢性肝病患者和56例正常人肝脏右叶进行检查,测得感兴趣区肝脏组织弹性量化值,即声触诊组织量化值(virtual touch quantification,VTQ),并与肝脏穿刺病理结果相对照。结果①61例慢性肝病患者病理活检结果:S0期8例,S1期12例,S2期10例,S3期13例,S4期18例;②VTQ值与肝纤维化程度有很好的相关性(Spearman r=0.737,P<0.01),不同阶段肝纤维化VTQ平均值是,正常对照组=1.03±0.26,S0=1.05±0.20,S1=1.14±0.28,S2=1.36±0.45,S3=2.01±0.76,S4=2.43±0.39;③正常对照组与S0组与S1组之间、S0组与S1组之间的VTQ值差异无统计学意义(P>0.05),其他各组之间的VTQ值差异均有统计学意义(P=0.000或P=0.016)。结论声脉冲辐射力成像技术能够反映肝组织弹性硬度的定量性息,对评估肝纤维化程度有重要价值。

Objective To investigate the clinic value of acoustic radiation force impulse in the diagnosis of liver fibrosis.Methods The right lobes of the liver of 61 patients with chronic liver disease and 56 normal persons were checked by acoustic radiation force impulse imaging in order to measure quantitative value of liver tissue elasticity in regions of interest and contrasted with pathological findings.Results ①61 cases of biopsy results in patients with chronic liver disease were：8 cases of S0,12 cases of S1,10 cases of S2,13 cases of S3,18 cases of S4.②The VTQ values and degree of liver fibrosis had a good correlation（Spearman r=0.737,P〈0.01）.The average VTQ values of liver fibrosis at different stages were normal group=1.03±0.26,S0=1.05±0.20,S1=1.14±0.28,S2=1.36±0.45,S3=2.01±0.76,S4=2.43±0.39.The VTQ values among different degree of liver fibrosis between S0 and S1,normal group and S0,normal group and S1 had no statistical significance（P〉0.05）.Differences in other degree of liver fibrosis had statistical significance（P=0.000,P=0.016）.Conclusion Acoustic radiation force impulse imaging technology reflected quantitative information about the hardness of the liver tissue elasticity which had important value to assess the degree of liver fibrosis.