剪切波弹性成像技术测量肝脏弹性的影响因素分析

Analysis of influence factors on hepatic elasticity measurement with shear wave elastography

目的分析剪切波弹性成像（SWE）技术测量肝脏弹性的影响因素。方法选取2013年9至12月中国医科大学附属第一医院常规肝脏超声检查正常的健康志愿者共130名。采用SWE技术测量不同性别、年龄段、体位、呼吸时相、测量直径时受检者肝脏杨氏模量值,并采用t检验进行比较。肝脏杨氏模量值与年龄的关系分析采用Pearson相关分析。结果同一体位、同一呼吸时相、不同测量直径,同一体位、同一测量直径、不同呼吸时相受检者肝脏杨氏模量值差异均无统计学意义;同一呼吸时相、同一测量直径、不同体位受检者肝脏杨氏模量值差异有统计学意义（t值分别为18.88、18.97、18.82、18.94,P均〈0.05）。呼气末测量直径为10 mm时,无论平卧位还是左侧卧位,同一体位男性受检者肝脏杨氏模量值均略高于女性受检者肝脏杨氏模量值,但差异均无统计学意义。呼气末测量直径为10 mm时,无论平卧位还是左侧卧位,同一体位青年组（20-39岁）、中年组（40-60岁）、老年组（〉60岁）受检者肝脏杨氏模量值均依次增高,但仅青年组与老年组受检者肝脏杨氏模量值差异有统计学意义（t=-3.359、-3.397,P均〈0.05）。Pearson相关分析结果显示,呼气末测量直径为10 mm时,受检者平卧位、左侧卧位肝脏杨氏模量值均与年龄呈正相关（r=0.458、0.370,P均〈0.05）。结论运用SWE技术测量肝脏弹性时,受检者呼吸时相、性别及测量直径对肝脏弹性测量无显著影响,但受检者的体位及年龄影响肝脏弹性测量。

Objective To analyze the influence factors on hepatic elasticity measurement with shear wave elastography（SWE）.Methods There were 130 healthy volunteers enrolled in this study,all of them were examined normally by routine liver ultrasound in the First Affiliated Hospital of China Medical University from September to December 2013.The Young′s modulus value of liver was measured in different sex,ages,postures,breathing phases,measuring diameters,and the difference was compared by t-test.Correlations between Young′s modulus value of liver and age was analyzed by Pearson.Results No significant difference was detect for the Young′s modulus value of liver was in different measuring diameters at the same postures and breathing phases,there was also no significant difference in the different breathing phases at the same postures and measuring diameters.The difference of Young′s modulus value of liver was statistically significant in different postures at the same measuring diameters and breathing phases（t=18.88,18.97,18.82,18.94,respectively,all P〈0.05）.The Young′s modulus value of liver in male was slightly higher than in female subjects when the measuring diameter was 10 mm at end-expiratory,regardless of supine or left lateral position,but the difference was not statistically significant.The Young′s modulus value of liver was successively increased in the youth group（20-39 years）,middle-aged group（40-60 years）,older age-group（〉60 years） subjects when the measuring diameter was 10 mm at end-expiratory,regardless of supine or left lateral position,but only the difference between youth group and the older group was statistically significant（t=-3.359,-3.397,both P〈0.05）.Pearson correlation analysis showed that the Young′s modulus value of liver was positively correlated with age when the measuring diameter was 10 mm at end-expiratory,regardless of supine or left lateral position（r=0.458,0.370,both P〈0.05）.Conclusion When using SWE techniques to measure liver elasticity,the breathing phase,sex and measuring diameter have no significant effect on the liver elasticity measurement,but the subject′s position and age affect the liver elasticity measurement.