超声实时组织弹性成像评估慢性乙型肝炎肝纤维化的价值

The value of ultrasound real-time tissue elastography in the evaluation of liver fibrosis in chronic hepatitis B

目的探讨慢性乙型肝炎肝纤维化患者应用超声实时组织弹性成像评估的临床价值。方法将2016年4月～2018年3月期间在我院就诊的60例慢性乙型肝炎患者选为研究组,同期接受健康体检的60例健康者选为对照组。两组患者均给予超声实时组织弹性成像检查,以病理学检查为准,分析研究组患者超声实时组织弹性成像检查的特异度、灵敏度与准确性,同时比较两组检查的应变均值(MEAN)、标准差(SD)、对比度(CONT)、复杂度(COMP)、偏度(SKEW)、峰度(KURT)、均等性(ENT)、相关性(CORR)。结果研究组60例患者中,病理学检查结果为肝纤维化42例,无肝纤维化18例;超声实时组织弹性成像检查结果为肝纤维化41例,无肝纤维化19例,特异度为88.9%,灵敏度为92.9%,准确性为91.7%。研究组MEAN、KURT值低于对照组,SD、CONT、COMP、SKEW值高于对照组,差异显著(P<0.05),但两组ENT、CORR值比较无显著性差异(P>0.05)。结论慢性乙型肝炎肝纤维化患者应用超声实时组织弹性成像评估的临床价值非常高,具有简单、无创、可重复等优势,值得临床应用与推广。

Objective To analyze the clinical value of real-time tissue elastography in patients with chronic hepatitis B liver fibrosis. Methods 60 patients with chronic hepatitis B who were admitted in our hospital from April 2016 to March 2018 were selected as the study group. 60 healthy individuals who underwent physical examination at the same time were selected as the control group. Ultrasound real-time tissue elastography was performed in both groups. The pathology examination was used to analyze the specificity, sensitivity and accuracy of ultrasound real-time tissue elastography in the study group. The mean strain (MEAN) Standard deviation (SD), contrast (CONT), complexity (COMP), skewness (SKEW), kurtosis (KURT), equality (ENT), correlation (CORR) between the two groups was compared. Results Of the 60 patients in the study group, pathological examination results showed that 42 patients had liver fibrosis and 18 had no liver fibrosis. Ultrasound real-time tissue elastography showed 41 cases of liver fibrosis and 19 cases of no liver fibrosis, with the specificity of 88.9%, sensitivity of 92.9% and accuracy of 91.7%. The values of MEAN and KURT in the study group were lower than those in the control group. The SD, CONT, COMP and SKEW values in the observation group were higher than those in the control group, and the difference was significant(P<0.05). But there was no significant difference in ENT and CORR between the two groups (P>0.05). Conclusion The ultrasound real-time tissue elastography in patients with chronic hepatitis B liver fibrosis has very high clinical value, with simple, non-invasive and repeatable advantages, which is worthy of clinical application and promotion.