ARFI技术评价肝纤维化的应用研究

Acoustic Radiation Force Impulse in the Noninvasive Diagnosis of Liver Fibrosis

为研究声脉冲辐射力超声技术(acoustic radiation force impulse,ARFI)无创定量评价肝纤维化的应用价值。应用ARFI技术定量检测158例部分乙肝患者和志愿者的肝实质剪切波速度,同时所有的慢性乙肝患者均在ARFI检查后随访穿刺活检病理学检查结果。结果显示,研究显示S0与S1期的弹性参数没有明显的差异,但对于评价S2级以上程度的肝纤维化,ARFI技术均有较高的准确性,特别是对S4期肝纤维化,ROC曲线下面积达0.942,且超声弹性成像评分与肝纤维化病理学分期之间呈正相关(r=0.875,P=0.000)。由此可知,应用ARFI技术检测各期慢性乙肝肝纤维化横向剪切波速的佳截断值可能成为诊断肝纤维化各分期的重要依据。

Objective： To research the value of ARFI technique in the prediction of liver fibrosis. Methods： ARFI was used in the quantitative detection of 158 cases of partial hepatitis B patients and volunteers for the liver parenchyma shear wave velocity;after the ARFI examination,all the patients with chronic hepatitis B received pathological examination of the biopsy. Results： The study showed that there was no significant relation between SO and $1 ,and ARFI technology had a higher accuracy for liver fi- brosis evaluation level, the level of S2 S4,especially for S4, the area under the ROC curve of 0. 984. And there was significant positive correlation between the ultrasound elastography score and the degree of hepatic fibrosis pathological stage （r=0. 875, P= 0. 000）, Conclusion： Application of ARFI technology to the detection of chronic hepatitis B liver fibrosis for the best cutoff value of shear wave velocity may become an important basis for each stage of the diagnosis of liver fibrosis.