剪切波弹性成像与瞬时弹性成像对慢性乙型肝炎肝纤维化的诊断价值分析

Analysis of values of shear wave elastography and transient elastography in diagnosis of hepatic fibrosis in patients with chronic hepatitis B

目的:分析剪切波弹性成像(SWE)与瞬时弹性成像(FibroScan)对慢性乙型肝炎肝纤维化的诊断价值。方法:选取200例慢性乙型肝炎患者作为研究对象,实施常规超声、SWE、FibroScan检查,以穿刺活检为金标准,观察病理检查结果,并比较SWE、FibroScan检测肝纤维化的弹性模量及3种检查方式对肝纤维化的诊断效能。结果:病理检查结果显示,阴性(S0期)80例,阳性120例,其中S1期40例,S2期28例,S3期28例,S4期24例;随着慢性乙型肝炎肝纤维化病理分期的增加,SWE、FibroScan弹性模量呈逐渐升高的趋势,差异均有统计学意义(P<0.05);SWE与FibroScan检测的特异度、敏感度、准确度高于常规超声检查,差异均有统计学意义(P<0.05)。SWE与FibroScan诊断慢性乙型肝炎的特异度、敏感度、准确度比较,差异无统计学意义(P>0.05)。结论:SWE与FibroScan检测应用在慢性乙型肝炎肝纤维化的诊断中,均具有较高的价值,临床可根据患者的具体情况,选择合理的方式为患者实施检测。

Objective: To explore values of shear wave elastography(SWE) and transient elastography(FibroScan) in diagnosis of hepatic fibrosis of patients with chronic hepatitis B. Methods: 200 patients with chronic hepatitis B were selected as the research subjects, and were examined by routine ultrasound, SWE, and FibroScan were performed. Taking the biopsy as the gold standard, observe the results of pathological examination, and compare the elastic modulus of SWE and FibroScan. Using the puncture biopsy as the gold standard, the results of the pathological examination were observed, and the elastic modulus of SWE and FibroScan were compared. Then, the diagnostic efficiencies of the three methods were compared. Results: The pathological examination showed that 80 cases were negative(S0 stage) and 120 cases were positive, including 40 cases of stage S1, 28 cases of stage S2, 28 cases of stage S3, and 24 cases of stage S4. With the increase of the pathological stage of chronic hepatitis B liver fibrosis, the elastic modulus of SWE and FibroScan showed a gradual increase trend, and the differences were statistically significant(P<0.05). The specificities, sensitivities and accuracies of SWE and FibroScan were higher than those of routine ultrasound examination, and the differences were statistically significant(P<0.05). However, there were no statistical differences in the specificity, sensitivity and accuracy between SWE and FibroScan(P>0.05). Conclusions: SWE and FibroScan both have higher value in the diagnosis of hepatic fibrosis of the patients with chronic hepatitis B. Therefore, the clinic should choose the reasonable way according to the specific situation of the patient.