组织结构声学定量技术无创评估慢性乙型肝炎肝纤维化的临床研究

Clinical study on non-invasive assessment of chronic fibrosis of chronic hepatitis B by tissue structure acoustic quantitative technique

目的探讨超声组织结构声学定量技术(ASQ)无创评估慢性乙型肝炎肝纤维化的可行性。方法采用配备ASQ分析软件的超声诊断仪,对308例受试者进行ASQ分析。受试者包括120例健康志愿者(归入S0期)、73例肝穿确诊慢性乙型肝炎肝纤维化患者(根据肝活检病理结果分为S1~S3期)、115例临床确诊为慢性乙型肝炎肝硬化患者(归入S4期),相关结果用红蓝曲线表示的频数直方图和相应参数值表示,对其进行记录、比较。将所得参数按病理肝纤维化程度分级并进行分析。结果ASQ定量技术各参数差异均有统计学意义,其中B/R-Ratio值与肝纤维化程度相关性最高(r=0.83,P<0.05),且随着肝纤维化程度的进展而增加。受试者工作特征(ROC)曲线,对应S0~S1 vs.S2~S4、S0~S2 vs.S3~S4、S0~S3 vs.S4的曲线下面积分别为0.924、0.951和0.923。结论ASQ在无创评估慢性乙型肝炎肝纤维化方面具有较高的应用价值。

Objective To investigate the feasibility of non-invasive assessment of ultrasonic tissue structure acoustics(ASQ)for chronic fibrosis of chronic hepatitis B.Methods ASQ analysis was performed on 308 subjects using an ultrasound diagnostic instrument equipped with ASQ analysis software.The subjects included 120 healthy volunteers(S0),73 patients with liver fibrosis diagnosed with chronic hepatitis B(S1 to S3),and 115 patients with clinically confirmed chronic hepatitis B cirrhosis(S4).The related results were represented by the frequency histograms and corresponding parameter values represented by red and blue curves,which are recorded and compared.The obtained parameters were classified according to the degree of pathological liver fibrosis and analyzed.Results The differences in the parameters of ASQ quantitative technology were statistically significant.The B/R-Ratio value had the highest correlation with the degree of liver fibrosis(r=0.83,P<0.05),and it increased with the progress of liver fibrosis.The receiver operating characteristic curve(ROC curve)of B/R-Ratio value,corresponded to S0-S1 vs.S2-S4,S0-S2 vs.S3-S4,S0-S3 vs.S4,the area under the curve were 0.924,0.951,and 0.923.Conclusion ASQ has higher application value in non-invasive assessment of chronic hepatitis B fibrosis.