实时组织弹性成像技术在评价脂肪肝肝纤维化程度中的应用价值

Application Value of Real-time Tissue Elastography in Evaluation of Fibrosis Stage of Fatty Liver

目的探讨实时组织弹性成像(realtime tissue elastography,RTE)技术在评价非酒精性脂肪肝肝纤维化程度中的价值。方法选择2011年7月—2012年12月在我院确诊的非酒精性脂肪肝300例,分为轻度脂肪肝组、中度脂肪肝组、重度脂肪肝组,每组100例,另选同期体检的100例健康受试者作为对照组。采用彩色多普勒超声诊断仪的组织弥散定量分析技术检测4组的肝脏硬度。观察4组体重指数和血脂水平、肝脏弹性图像的特征量值、肝脏硬度弹性指数。结果脂肪肝各组体重指数、血脂水平、肝脏弹性图像杂乱性、标准差、偏度、蓝色区域、对比度及肝组织硬度弹性指数均高于对照组(P<0.05,P<0.01);体重指数和血脂水平、肝脏弹性图像杂乱性、对比度及肝组织硬度指数脂肪肝各组两两比较差异有统计学意义(P<0.05,P<0.01);轻度脂肪肝组肝脏弹性图像偏度低于中度和重度脂肪肝组,标准差和蓝色区域低于重度脂肪肝组(P<0.01)。结论 RTE技术的组织弥散定量分析可明确非酒精性脂肪肝肝纤维化程度,是一种新型定量检查方法。

Objective To explore the value of real-time tissue elastography （RTE） in evaluation of fibrosis stage of non-alcoholic fatty liver. Methods A total of 300 patients with non-alcoholic fatty liver diagnosed in our hospital during July 2011 and December 2012 were divided into mild, moderate and severe fatty liver groups （n = 100 each group.） , and 100 healthy volunteers were chosen as control group. The liver hardness was detected by tissue dispersion quantitative analysis software with color Doppler in each group. Body mass index （BMI） , blood fat level, features of liver elastography and hepatic hardness indexes in the four groups were observed. Results The BMI, blood fat level, elastography indexes of diversity, standard deviation, skewness, blue area, contrast degree and hardness index in the three fatty liver groups were significantly higher than those in control group （P 〈 0. 05, P 〈 0. 01 ） ; there were significant differences in BMI, blood fat level, elastography indexes of diversity, standard deviation, skewness, contrast degree and hardness index between any two fatty liver groups （P 〈 0. 05 ,P 〈 0. 01 ） ; indexes of standard deviation and blue area in mild fatty liver group were lower than those of severe fatty liver group （P 〈 0. 01）. Conclusion Tissue dispersion quantitative analysis of RTE technique is a new quantitative method to evaluate the fibrosis stage of non-alcoholic fatty liver.