2D-SWE联合CEUS对老年乙肝患者肝纤维化程度的评估

Evaluation of 2D-SWE Combined with CEUS on Liver Fibrosis in Elderly Patients with Hepatitis B

目的探讨二维剪切波弹性成像(2D-SWE)联合超声造影(CEUS)评估老年慢性乙型病毒性肝炎(简称乙肝)患者肝纤维化程度的价值。方法选取2019年7月至2020年8月我院接收的89例老年乙肝患者为研究对象,患者入院时均行2D-SWE与CEUS检查并记录相关参数[剪切波速度(SWV)、弹性模量、肝静脉到达时间(HVAT)、肝动脉-肝静脉渡越时间(HV-HAAT)],以肝穿刺活检结果为依据,判断患者肝纤维化程度并分组,分析2D-SWE联合CEUS在老年乙肝患者肝纤维化程度评估中的应用价值。结果经肝穿刺活检结果显示,89例老年乙肝患者中,肝纤维化轻度29例,中度38例,重度22例;重度组SWV、弹性模量均高于中度组,HVAT、HV-HAAT均短于中度组,且中度组SWV、弹性模量均高于轻度组,HVAT、HV-HAAT均短于轻度组,差异有统计学意义(P<0.05);经绘制ROC曲线发现,SWV、弹性模量、HVAT、HV-HAAT单独及联合评估老年乙肝患者肝纤维化程度的AUC值分别为0.738、0.720、0.729、0.801、0.826,均有一定评估性能。结论2D-SWE联合CEUS在老年乙肝患者肝纤维化程度评估中的应用价值较高。

Objective To evaluate the value of two-dimensional shear wave elastography(2D-SWE)combined with contrast-enhanced ultrasound(CEUS)in assessing the degree of liver fibrosis in elderly patients with chronic hepatitis B.Methods A total of 89 elderly patients with hepatitis B admitted in our hospital from July 2019 to August 2020 were selected.All patients underwent 2 D-SWE and CEUS examinations,and the relevant parameters[shear wave velocity(SWV),elastic modulus,hepatic vein arrival time(HVAT),hepatic artery hepatic vein transit time(HV-HAAT)]were recorded,and the results were based on the results of liver biopsy.To evaluate the degree of liver fibrosis and to analyze the value of 2D-SWE combined with CEUS in evaluating the degree of liver fibrosis in elderly patients with hepatitis B.Results According to the results of liver biopsy,89 cases of elderly hepatitis B patients had mild liver fibrosis in 29 cases,moderate in 38 cases and severe in 22 cases.SWV and elastic modulus in severe group were higher than those in moderate group,HVAT and hv-haat were shorter than those in moderate group,SWV and elastic modulus in moderate group were higher than those in mild group,and HVAT and hv-haat were shorter than those in mild group(P<0.05);After drawing the ROC curve,it was found that the AUC values of SWV,elastic modulus,HVAT and HV-HAAT alone and combined in assessing the degree of liver fibrosis in elderly patients with hepatitis B were 0.738,0.720,0.729,0.801,0.826,respectively,all of which had certain evaluation performance.Conclusion 2D-SWE combined with CEUS is of high value in evaluating the degree of liver fibrosis in elderly patients with hepatitis B.