计算机辅助超声定量评估脂肪肝的应用价值初探

A preliminary study on the application value of computer assisted ultrasound in quantitative evaluation of fatty liver

目的探讨计算机辅助超声定量评估脂肪肝的可行性及稳定性。方法选取2019年4月至2020年3月在本院体检中心就诊并接受超声检查的患者147例,根据肝脏声像图分为健康对照组(n=65)和脂肪肝组(n=82)。采用计算机软件定量分析肝肾切面声像图,计算肝肾灰度值,并采用ROC曲线诊断脂肪肝的肝肾比值(hepatorenal ratio,H/K比值)的截断点,并与血脂水平进行相关性分析。比较两组肝肾灰度值,分析H/K比值评估脂肪肝的诊断价值及与血脂水平的相关性。结果脂肪肝组H/K比值为(1.88±0.54),明显高于健康对照组的(1.34±0.38),差异有统计学意义(P<0.05)。ROC曲线结果显示,采用H/K比值鉴别脂肪肝的最佳截断值为1.5,相应敏感度、特异度分别为82.9%和72.3%,ROC曲线下面积为0.825。组内相关系数(intraclass correlation coefficient,CC)分析结果显示,H/K比值与甘油三酯水平呈正相关,ICC系数为0.84。结论采用计算机软件定量分析肝肾超声图像可有效鉴别脂肪肝并定量分析肝脏脂肪化的程度。H/K比值与甘油三酯水平呈正相关,在脂肪肝鉴别诊断方面具有较高的稳定性。

Objective To investigate the feasibility and stability of quantitative evaluation of fatty liver by computer-assisted ultrasound.Methods 147 patients who received ultrasound examination in the physical examination center of our hospital from April 2019 to March 2020 were selected and divided into healthy control group(n=65)and fatty liver group(n=82)according to liver ultrasonography.The ultrasonography of liver and kidney section was quantitatively analyzed by computer software,the gray values of liver and kidney were calculated,and the cut-off point of hepatorenal ratio(H/K ratio)was diagnosed by ROC curve,and the correlation analysis was conducted with blood lipid level.The gray values of liver and kidney were compared between the two groups,and the diagnostic value of H/K ratio was analyzed to evaluate fatty liver and its correlation with blood lipid level.Results The H/K ratio of fatty liver group(1.88±0.54)was significantly higher than that of healthy control group(1.34±0.38),and the difference was statistically significant(P<0.05).ROC curve results showed that the optimal truncation value of H/K ratio was 1.5,the corresponding sensitivity and specificity were 82.9%and 72.3%,respectively,and the area under the ROC curve was 0.825.The results of intra-lass correlation coefficient(ICC)analysis showed that H/K ratio was positively correlated with triglyceride level,the ICC coefficient was 0.84.Conclusion Using computer software to quantitatively analyze liver and kidney ultrasound images can effectively identify fatty liver and quantitatively analyze the degree of liver fatty.H/K ratio is positively correlated with triglyceride level,and has a high stability in the differential diagnosis of fatty liver.