实时剪切波弹性成像在非酒精性脂肪肝分度诊断中的应用价值

Application value of shear wave elastography in diagnosis of non-alcoholic fatty liver graduation

目的探讨实时剪切波弹性成像(SWE)在非酒精性脂肪肝分度诊断中的应用价值。方法将158例非酒精性脂肪肝患者(脂肪肝组)分为轻度(n=52)、中度(n=51)、重度(n=55)3个亚组,另选健康成人50例为正常对照组。所有受检者均行常规超声扫查,再应用SWE测量肝杨氏模量值,比较各组杨氏模量值的差异。Spearman相关分析肝杨氏模量值与肝脏脂肪变程度的关系。结果正常对照组与脂肪肝组肝脏杨氏模量值分别为(4.79±0.77)k Pa和(4.51±0.57)k Pa,两组比较差异有统计学意义(t=2.562,P<0.05)。轻、中、重度脂肪肝组杨氏模量值分别为(4.73±0.68)k Pa、(4.49±0.58)k Pa及(4.42±0.61)k Pa,正常对照组及脂肪肝各亚组间肝杨氏模量值比较差异有统计学意义(F=3.965,P<0.05),轻、重度脂肪肝组间比较差异有统计学意义(t=0.338,P<0.05),轻度脂肪肝组与正常对照组及中度脂肪肝组比较差异均无统计学意义。肝杨氏模量值与肝脏脂肪变程度呈弱负相关(r=-0.185,P<0.05)。结论 SWE在评价脂肪肝分度上具有一定临床价值,可推广应用。

Objective To investigate the application value of shear wave elastography （ SWE ） in diagnosis of nonalcoholic fatty liver graduation. Methods One hundred and fifty-eight patients with non-alcoholic fatty liver（fatty liver group ） were divided into mild subgroup （n=52）, moderate subgroup （n=51） and severe subgroup （n=55）, and 50 healthy subjects were enrolled as control group. All subjects underwent conventional ultrasound and then measured liver Young＇s modulus by SWE, the results were analyzed and compared.The correlation between Young＇s modulus and steatosis was analyzed by Spearman correlation analysis. Results The Young＇ s modulus of liver in the control group and fatty liver group were（4.79±0.77）kPa and （4.51±0.57 ）kPa, there was significant difference （t=2.562, P〈0.05 ）.The liver Young＇ s modulus successively reduced as the severity of fatty, mild subgroup was （4.73±0.68）kPa, moderate subgroup was （4.49±0.58）kPa, and severe subgroup subgroup was （4.42±0.61）kPa, and the difference among the groups was statistically significant（F=3.965, P〈0.05 ）. Spearman correlation analysis showed that the Young＇s modulus was negatively correlated with liver steatosis （r=-0.185, P〈0.05 ）. Conclusion SWE may have important clinical value in evaluation of the severity degree of fatty liver.