声触诊组织量化技术评估经颈静脉肝内门-腔分流术术后疗效的应用价值

Value of virtual touch tissue quantification in evaluating therapeutic effects of transjugular intrahepatic portosystemic stent shunt

背景声触诊组织量化(virtual touch tissue quantification,VTQ)技术是一种能定量分析目标组织弹性硬度的超声新技术,具有便捷、无创、可重复等优点.通过定量分析经颈静脉肝内门-腔分流术(transjugular intrahepatic portosystemic stent shunt,TIPSS)后肝脏及脾脏的组织硬度变化,客观反映其临床治疗效果,有望为TIPSS术后疗效评估提供一种有价值的影像学手段.目的探讨VTQ技术评估TIPSS疗效的临床应用价值.方法选取在我院拟行TIPSS术的52例肝硬化门静脉高压患者作为研究对象,分别于术前1 d、术后1 mo采用VTQ技术测定肝剪切波速度(shear wave velocity,SWV)值、脾SWV值,并作比较分析.结果TIPSS术后门静脉、脾静脉流速较术前增快,差异有统计学意义(P<0.05);门静脉内径较术前减少,差异有统计学意义(P<0.05);TIPSS术后肝SWV值及脾SWV值较术前下降,差异有统计学意义(P<0.05).结论VTQ技术可无创性测定肝脾SWV值,能有效监测TIPSS术后疗效,具有一定临床应用价值.

BACKGROUND Virtual touch tissue quantification(VTQ)is a new ultrasonic technology which can quantitatively analyze the elastic hardness of tissue.It is convenient,noninvasive,and repeatable.In the present study,the changes of tissue hardness of the liver and spleen after transjugular intrahepatic portosystemic stent shunt(TIPSS)were analyzed quantitatively to assess the clinical therapeutic effects,with an aim to provide a valuable imaging method for the evaluation of therapeutic effects of TIPSS.AIM To explore the clinical value of VTQ in evaluating the therapeutic effects of TIPSS.METHODS Fifty-two cirrhotic patients with portal hypertension were selected as subjects.The shear wave velocity(SWV)of the liver and spleen was measured by VTQ one day before operation and one month after operation,and the changes of SWV of the liver and spleen were compared.RESULTS The velocities of the portal vein and splenic vein after TIPSS increased significantly compared with those before TIPSS(P<0.05).The diameter of the portal vein after TIPSS decreased significantly compared with that before TIPSS(P<0.05).The SWV of the liver and spleen after TIPSS decreased significantly compared with those before TIPSS(P<0.05).CONCLUSION VTQ is a noninvasive method to measure the SWV of the liver and spleen,which can effectively monitor the therapeutic effect of TIPSS.