实时剪切波弹性成像超声定量检测评估儿童脂肪肝的应用价值

Quantitative detection of fatty liver in children by real-time shear wave elastography

目的研究实时剪切波弹性成像(SWE)超声定量检测评估儿童非酒精性脂肪肝(NAFLD)的应用价值。方法纳入2019年1月至2019年9月于我院收治的96例NAFLD患儿为观察组,另选取124例正常儿童为对照组,均采用SWE技术测量肝杨氏模量值。比较两组杨氏模量测值及血清谷丙转氨酶、谷草转氨酶水平,分析杨氏模量测值与NAFLD严重程度、肝功能指标的关系,并判断杨氏模量测值对儿童NAFLD的预测价值。结果观察组杨氏模量测值显著低于对照组(P<0.05),血清谷丙转氨酶、谷草转氨酶显著高于对照组(P<0.05)。血清谷丙转氨酶、谷草转氨酶与NAFLD患儿杨氏模量测值均呈正相关(r=0.322、0.467,P=0.000、0.000)。96例NAFLD患儿中,轻度NAFLD32例,中度NAFLD31例,重度NAFLD33例。轻度NAFLD者杨氏模量测值显著高于中度NAFLD和重度NAFLD者(P<0.05),中度NAFLD者杨氏模量测值显著高于重度NAFLD者(P<0.05)。杨氏模量测值对儿童NAFLD有一定预测价值,曲线下面积为0.895。结论 SWE技术在评估儿童NAFLD及其病变严重程度方面具有重要作用,可用于儿童NAFLD早期筛查。

Objective To study the value of real-time shear wave elastography(SWE)in quantitative detection of nonalcoholic fatty liver disease(NAFLD)in children.Methods 96 children with NAFLD admitted to our hospital from January 2019 to September 2019 were selected as the observation group,and 124 normal children as the control group.The Young′s modulus of liver was measured by SWE technique.Young′s modulus and serum alanine aminotransferase and glutamic oxaloacetic aminotransferase levels were compared between the two groups.The relationship between Young′s modulus and severity of NAFLD and liver function indexes was analyzed,and the predictive value of Young′s modulus for children′s NAFLD was judged.Results The young′s modulus of the observation group was significantly lower than that of the control group(P<0.05),and the serum GPT and GST were significantly higher than that of the control group(P<0.05).Serum alanine aminotransferase and glutamic oxaloacetic aminotransferase were positively correlated with Young′s modulus in children with NAFLD(r=0.322,0.467,P=0.000,0.000).Among 96 cases of NAFLD,32 cases were mild NAFLD,31 cases were moderate NAFLD and 33 cases were severe NAFLD.The young′s modulus of mild NAFLD was significantly higher than that of moderate NAFLD and severe NAFLD(P<0.05),and the young′s modulus of moderate NAFLD was significantly higher than that of severe NAFLD(P<0.05).Young′s modulus has a certain predictive value for children′s NAFLD,and the area under the curve is 0.895.Conclusion SWE plays an important role in assessing the severity of NAFLD and its lesions in children,and can be used for early screening of NAFLD in children.