实时超声弹性成像诊断慢性乙肝并肝纤维化程度的价值研究

Value of real time ultrasound elastography in diagnosis of the degree of chronic hepatitis B combined withhepatic fibrosis

目的评价实时超声弹性成像(Real-time tissue elastofraphy,RTE)技术用于评价慢性乙肝并肝纤维化程度的价值。方法选择2016年9月~2017年10月我院消化内科、肝胆外科、传染科收治的慢性乙肝并肝纤维化患者合计155例为本次研究对象。所有患者均进行RTE诊断并行肝病理穿刺检查,并与RTE诊断结果进行比较分析。结果 155例患者均顺利完成RTE及病理检验。155例患者中S0期38例、S1期31例、S2期26例、S3期18例、S4期42例。RTE结果评分随病理分期增加而增加(相关性系数r值为0.631,P<0.001)。RTE诊断慢性乙肝并肝纤维化特异度:80.49%、灵敏度:95.61%、准确度:91.61%。结论 RTE诊断慢性乙肝并肝纤维化具有高准确性、灵敏度、特异度,与病理分期具有较好相关性,可为临床诊断提供影像学依据,且无创、可重复性的优势值得临床应用与推广。

Objective To evaluate the value of real-time tissue elastofraphy （RTE） in evaluating the degree of hepatic fibrosis combined with chronic hepatitis B. Methods A total of 155 patients with chronic hepatitis B combined with liver fibrosis who were admitted in the Department of Gastroenterology, Hepatobiliary Surgery and Infectious Diseases from September 2016 to October 2017 were selected as the study objects. All patients underwent RTE diagnosis and patho- logical liver biopsy, and the biopsy results were compared with the diagnostic results of RTE. Results All 155 patients successfully completed RTE and pathological examination. Of the 155 patients, 38 were in stage SO, 31 in stage S1, 26 in stage S2, 18 in stage S3, and 42 in stage S4. The score of RTE increased with the increase of pathological staging （r=0.631, P〈0.001）. The specificity of RTE in diagnosis of chronic hepatitis B combined with liver fibrosis was 80.49%, 95.61% and 91.61%. Conclusion RTE has high accuracy, sensitivity and specificity in diagnosis of chronic hepatitis B combined with liver fibrosis, and has good correlation with pathological stage, which can provide imaging basis for clinical diagnosis,with the advantages of non-invasive and reproducible and is worthy of clinical application and promotion.