肝脏的剪切波速度在婴幼儿黄疸中的诊断价值

Value of shear wave velocities in diagnosis of neonates and infants cholestasis

目的探讨肝脏的剪切波速度（shear wave velocity,SWV）在婴幼儿黄疸中的诊断价值。方法收集婴幼儿黄疸32例,应用Acuson S2000彩色多普勒超声诊断仪声触诊组织定量技术（virtual touch quantification,VTQ）模式测量肝脏的SWV。通过术中胆道造影和肝脏组织活检病理确诊。依据病理肝纤维化Metavir分级,分为胆道闭锁组（n=15）和非胆道闭锁组（n=17）。选择18例婴幼儿志愿者（无黄疸或肝脏其他疾病）作为对照组,比较胆道闭锁组、非胆道闭锁组和对照组肝脏的SWV。结果胆道闭锁组肝脏的SWV为（2.21±0.73）m/s,明显高于非胆道闭锁组的（1.34±0.18）m/s（P〈0.01）和对照组的（1.03±0.12）m/s（P〈0.01）,而非胆道闭锁组与对照组之间差异无统计学意义（P〉0.05）。根据术中肝脏组织活检病理进行肝纤维化Metavir分级,胆道闭锁组为F2~F4,非胆道闭锁组为F0~F1。结论肝脏的SWV在区分胆道闭锁及其他原因引起的婴幼儿黄疸中有重要的价值。

Objective To investigate the value of shear wave velocity（SWV）on liver tissue in diagnosis of neonates and infants cholestasis.Methods SWV was performed in 32 neonates and infants using an Acuson S2000 US system,SWV in virtual touch quantification（VTQ）mode,cholangiography was confirmed by operation.The liver biopsy samples were collected during operation.According to Metavir score system,32 neonates and infants cholestasis were divided into two groups,biliary atresia（n=15）and non-biliary atresia（n=17）.At the same time,18 healthy volunteers（without jaundice or liver disease）were selected as control group.The value of SWV on liver tissue was compared between disease group and control group.Results Mean SWV in patients with biliary atresia（2.21±0.73）m/s was significantly larger than that in patients with non-biliary atresia group（1.34±0.18）m/s（P〈0.01）and control subjects（1.03±0.12）m/s（P〈0.01）.SWV showed no significant difference between non-biliary atresia group and control group（P〉0.05）;Metavir liver fibrosis scores ranged from 2to 4for the biliary atresia group and from 0to 1for the non-biliary group.Conclusion SWV has important values in discriminating biliary atresia from other causes of neonates and infants cholestasis.