声触诊弹性成像不同取值方法诊断肝纤维化的对比分析

Comparative analysis of sound touch elastography for assessing liver fibrosis by different value methods

目的探讨声触诊弹性成像(STE)两种取值方法诊断慢性乙型肝炎(CHB)肝纤维化的应用价值。方法对122例CHB患者行STE检查,获得各病理分期肝弹性模量值的均值和中位数,计算均值、中位数两种取值方法与病理分期的相关系数;绘制受试者工作特征(ROC)曲线分析两种取值方法对肝纤维化的诊断效能,比较曲线下面积的差异。结果均值、中位数两种取值方法的弹性模量值在各病理分期间比较差异均有统计学意义(F=36.894、28.667,均P<0.001);均值、中位数两种取值方法与病理分期均呈正相关(r=0.641、0.598,均P<0.001)。以均值为取值方法诊断肝纤维化≥S2期及S4期的曲线下面积稍高于以中位数为取值的方法,差异均无统计学意义;以均值为取值方法诊断肝纤维化≥S3期的曲线下面积高于以中位数为取值的方法,差异有统计学意义(P<0.05)。结论 STE诊断CHB患者肝纤维化具有一定的应用价值,选择肝弹性模量值均值为检查参数较中位数的诊断价值更高。

ObjectiveTo explore the value of two methods of sound touch elastography(STE)in diagnosing liver fibrosis in patients with chronic hepatitis B(CHB).MethodsA total of 122 patients with CHB were selected in our hospital.All patients were successfully examined by STE.The mean and median values of Young’s modulus were obtained,and the correlation coefficients between the mean,median values and pathological stages were calculated.The diagnostic efficacy of the two methods for liver fibrosis was analyzed by receiver operator characteristic(ROC)curve,and the area under ROC curve was compared.ResultsThe Young’s modulus values of the two methods were significant differences among the pathological staging groups(F=36.894,28.667,both P<0.001). The mean and median values of the two methods were positively correlated with pathological stages(r=0.641,0.598,both P<0.001).The area under ROC curve of mean values for diagnosing liver fibrosis ≥S2 stage and S4 stage was slightly higher than those of the median values,but there was no significant difference between the two groups.The area under ROC curve of mean values for diagnosing liver fibrosis ≥S3 stage was higher than that of median values,and the difference was statistically significant(P<0.05).ConclusionSTE has better diagnostic efficacy in evaluation of liver fibrosis in patients with CHB.It is more valuable to choose the mean value of the Young’s modulus as the parameter than the median value.