胆道闭锁肝脏超声实时剪切波弹性改变初步探讨

Preliminary research on the elastic changes in the liver of biliary atresia measured by ultrasonic real time shear wave elasticity

目的:初步探讨胆道闭锁(Biliary atresia,BA)患儿肝脏超声实时剪切波(Shear wave elastography,SWE)弹性改变。方法:应用SWE技术对25例BA患儿和同期30例婴儿肝炎综合征(IHS)患儿、23例肝功能正常婴儿肝脏进行检查,测量肝被膜下2 cm范围内肝脏硬度杨氏模量值,对各组肝脏杨氏模量值分布进行统计分析。结果:BA组、IHS组和正常组杨氏模量值分布分别为(18.10±10.70)k Pa、(6.68±1.98)k Pa和(5.69±0.70)k Pa。各组弹性杨氏模量值差异有统计学意义(F=35.14,P<0.05)。BA组与IHS组,IHS组与正常组杨氏模量值差异有统计学意义(t=5.506、2.499,P均<0.05)。BA组杨氏模量值随日龄增加呈线性分布(r=0.568,P<0.05),日龄越大杨氏模量值越大。结论:SWE可间接提示BA患儿肝纤维化程度,可以为二维超声诊断胆道闭锁提供肝脏硬度信息,并为临床医生选择胆道闭锁患儿手术时机和判断预后提供重要佐证。

Objective： To investigate the elastic changes of liver in children with biliary atresia（BA） with ultrasonic real time shear wave elasticity（SWE）. Method： Twenty-five cases of children with BA, 30 cases of infantile hepatitis syndrome（IHS）and 23 cases of infants with normal liver function were examined with SWE. The liver stiffness by Young ＇s modulus value was measured from the liver tissue locating about 2 cm from the liver border, and then compared among different groups.Result： The Young＇s modulus values of BA group, IHS group and the normal group were（18.10 ±10.70） k Pa,（6.68±1.98） k Pa and（5.69±0.70） k Pa, respectively, with a significant difference among the group（P〈0.05）. The Young＇s modulus values were significantly different between group BA and IHS, and between group HIS and normal group. The Young ＇s modulus value in group BA showed a positive linear relationship with the age. Conclusion： SWE may assess liver fibrosis in children with BA indirectly, and can provide information of liver stiffness for the diagnosis of biliary atresia. It can also provide important evidence for clinicians to select the operation time and determine prognosis of biliary atresia in children.