实时剪切波弹性成像对慢性乙型肝炎患者早期肝纤维化的诊断价值

Diagnostic value of real-time shear wave elastography for early hepatic fibrosis in patients with chronic hepatitis B

目的探究实时剪切波弹性成像技术(SWE)对慢性乙型肝炎(CHB)患者早期肝纤维化的诊断价值。方法回顾性分析2017年4月至2018年3月深圳市第二人民医院收治的160例CHB患者的临床资料,根据早期肝纤维化分期分为S1期组和S2期组,每组各80例;另选取同期健康体检者80例作为对照组。三组受检者均行SWE检测,对比三组受检者肝脏SWE杨氏模量,分析肝脏SWE杨氏模量值与肝纤维化分期之间的相关性及SWE检测对CHB早期肝脏纤维的诊断价值。结果S1期组、S2期组、对照组的肝脏SWE杨氏模量中位数分别为7.183 kPa、9.539 kPa、3.932 kPa(H=19.351,P<0.05)。经Spearman相关性分析,肝脏SWE杨氏模量值与肝纤维化分期呈正相关(r=0.875,P<0.05)。根据肝脏病理学检测结果,以肝脏SWE杨氏模量值6.8 kPa为临界值诊断肝纤维化,S1期组AUC为0.76,敏感度为81%,特异度为86%;SWE杨氏模量值9.3 kPa为临界值诊断肝纤维化,S2期组AUC为0.85,敏感度为85%,特异度为93%。结论SWE技术可定量测量CHB早期肝纤维化程度,且具有较高的诊断效能,其诊断敏感度、特异度均较高。

Objective To explore the value of real-time shear wave elastography(SWE)in the diagnosis of early hepatic fibrosis in patients with chronic hepatitis B(CHB).Methods The clinical data of 160 patients with CHB admitted to Shenzhen Second People's Hospital from April 2017 to March 2018 were retrospectively analyzed.According to the stage of early liver fibrosis,they were divided into S1 group and S2 group,with 80 cases in each group.Another 80 healthy people in the same period were selected as the control group.Three groups of subjects underwent SWE test,comparing the SWE Young's modulus of liver in three groups,analyzing the correlation between liver SWE Young's modulus value and liver fibrosis stage and SWE detection on CHB early liver fiber Diagnostic value.Results The median SWE of the SWE of the S1,S2 and control groups were 7.138 kPa,9.539 kPa,3.932 kPa(H=19.351,P<0.05).According to Spearman correlation analysis,the positive SWE of liver SWE was positively correlated with the stage of liver fibrosis(r=0.875,P<0.05).According to the results of liver pathology,liver fibrosis was diagnosed with the SWE Young's modulus value of 6.8 kPa as the critical value.The AUC of the S1 group was 0.76,the sensitivity was 81%,and the specificity was 86%.The SWE Young's modulus value Hepatic fibrosis was diagnosed with a critical value of 9.3 kPa.The AUC of the S2 group was 0.85,the sensitivity was 85%,and the specificity was 93%.Conclusion SWE technology can quantitatively measure the degree of early CHB liver fibrosis,and has high diagnostic efficiency,and its diagnostic sensitivity and specificity are high.