瞬时弹性成像联合彩色多普勒超声半定量评分在早期肝炎肝硬化诊断中的应用价值

Application of FibroScan combined with ultrasonic semi-quantitative scoring for early-stage viral liver cirrhosis

目的：评价瞬时弹性成像（FibroScan）联合彩色多普勒超声半定量评分在诊断早期肝炎肝硬化中的应用价值。方法：选择40例慢性乙型肝炎患者,进行常规实验室检查、肝脏活组织检查、FibroScan检查和彩色多普勒超声检查,运用受试者工作特征曲线（ROC curve）分析FibroScan检查与彩色多普勒超声检查两者单独及联合运用与早期肝硬化（S3~S4）诊断的相关性。结果：FibroScan和彩色多普勒超声半定量评分对早期肝硬化（S3~S4））的曲线下面积（AUROC）和95%可信区间（95%CI）分别为0.894（0.780~1.00）,0.718（0.517~0.918）,敏感度和特异度分别为0.718（1.00）,0.59（0.75）,两者联合后对早期肝硬化（S3~S4）的曲线下面积（AUROC）和95%可信区间（95%CI）为0.935（0.845~1.00）,敏感度和特异度为0.74（1.00）。结论：FibroScan联合彩色多普勒超声半定量评分对诊断早期肝硬化准确度更高,误诊率更低,对指导临床选择抗病毒治疗,提前干预早期肝硬化具有重要意义。

Objective： To evaluate the value of the FibroScan combined with the color doppler ultrasound m the diagnosis ot early-stage liver cirrhosis. Methods： Fourty patients with liver biopsy who were diagnosed chronic hepatitis B were chosen. Routine laboratory tests, Fi- brosean and color doppler ultrasound were carried out ; The correlation between the two methods separate and combined use and early liver cir- rhosis （ S3 ~ S4） diagnosis were drawn out by receiver operating characteristic curve （ ROC curve）. Results： The area under the ROC curve （ AUROC value） of FibroScan and ultrasonic semi-quantitative scoring for early-stage viral liver cirrhosis （ S3 ~ S4 stage） were 0.894 （0. 780 ~ 1.00 ） and 0.718 （ 0. 517 ~ 0. 918 ）, respectively; the sensitivity and specificity of FihroScan and ultrasonic semi-quantitative scoring were 0. 718 （1.00） and 0. 59 （ 0.75 ） , respectively; The AUROC value of combination FibroScan with ultrasonic semi-quantitative scoring was 0. 935 （95% CI：0. 845 - 1.00） for early-stage viral liver cirrhosis and the sensitivity and specificity was 0.74 （1.00）. Conclusion： FibroScan com- bined with ultrasonic semi-quantitative scoring diagnostic model could significantly improve the diagnosis effectiveness of early-stage viral liver cirrhosis, and thus help clinicians choose antiviral therapy and early intervention in treating liver fibrosis.