VTQ技术评估早期酒精性肝硬化的价值

Clinical value of Virtual Touch Tissue Quantification for evaluating early alcoholic liver cirrhosis

目的探讨声触诊组织量化技术(virtual touch tissue quantification,VTQ),诊断酒精性肝病(alcoholic liver disease,ALD)早期硬化的价值。方法采用VTQ技术对2013年5月—2015年9月于杭州市西溪医院就诊的3组154例受检者(酒精性肝病组63例、早期酒精性肝硬化组41例及健康对照组50例)进行肝脏右叶弹性检测并记录。所有患者均于检测一周后,行肝脏穿刺活检,以病理检查为金标准,比较VTQ技术对早期酒精性肝硬化的诊断价值。通过受试者工作特征曲线(receiver operating characteristic curve,ROC)分析确定界值。结果对照组、酒精性肝病组及早期酒精性肝硬化组的VTQ值分别为(1.14±0.14)m/s、(1.48±0.27)m/s、(2.33±0.48)m/s。两两组间比较VTQ值差异有统计学意义(P<0.001),VTQ技术诊断酒精性肝病早期肝硬化组的ROC曲线下面积为0.955。鉴别酒精性肝病和早期硬化的VTQ界值为1.78 m/s,其诊断的敏感度(sensitivity,Se)和特异度(specificity,Sp)分别为85.7%和95.1%。结论 VTQ技术能够定量反映肝组织的硬度,对诊断早期酒精性肝硬化有较高的价值。

Objective To investigate the diagnostic value of virtual touch tissue quantification（ VTQ） technique for early alcoholic liver cirrhosis. Methods The right lobes of liver of 154 people in three groups（ 63 patients with alcoholic liver disease,41 patients with early liver alcoholic cirrhosis and 50 healthy controls） were checked and recorded by VTQ technique. One week later,all the patients underwent liver biopsy. The pathological examination result was used as the gold standard to evaluate the diagnostic value of VTQ technique for early alcoholic liver cirrhosis. The cut- off value was determined by an analysis of receiver operating characteristic curve（ ROC）. Results The average velocity of VTQ was（ 1. 14 ± 0. 14） m/s,（ 1. 48 ± 0. 27） m/s,（ 2. 33 ± 0. 48） m/s in control,ALD and early alcoholic liver cirrhosis group,respectively. Significant difference were found among these three groups（ P〈 0. 001）. The area under the ROC curve was0. 955 by using the VTQ technique in the assessment of early alcoholic liver cirrhosis. The VTQ value of 1. 78 m / s was used as cut- off value to distinguish between ALD and early liver cirrhosis. The sensitivity（ Se） and specificity（ Sp） to diagnose early cirrhosis was 85. 7% and 95. 1%. Conclusion VTQ technique can quantitatively reflect liver tissue stiffness information,which has high value to diagnose early alcoholic liver cirrhosis.