2D-SWE对自身免疫性肝病病人肝纤维化程度的诊断价值

Value of two-dimensional shear wave elastography in diagnosis of liver fibrosis degree in patients with autoimmune liver disease

目的探讨二维剪切波弹性成像(2D-SWE)对自身免疫性肝病(AILD)病人肝纤维化程度的诊断价值。方法选取就诊于我院的66例AILD病人行2D-SWE检查和肝组织穿刺活检。根据肝穿刺活检病理结果,将病人分为肝纤维化组和对照组,比较两组病人以及不同病理分期肝纤维化病人的弹性模量值(EMV)。采用受试者工作特征(ROC)曲线分析2D-SWE预测AILD病人肝纤维化程度的临床价值。结果肝纤维化组病人的肝脏EMV显著高于对照组,差异具有统计学意义(t=4.470,P<0.001);不同病理分期肝纤维化病人的EMV相比较差异具有统计学意义(F=17.570,P<0.001)。AILD病人肝脏EMV与肝纤维化组织学分期呈正相关(r=0.987,P<0.001)。2D-SWE测定的肝脏EMV诊断肝纤维化的灵敏度为78.4%,特异度为86.7%,漏诊率为21.6%,误诊率为13.3%,ROC曲线下面积为0.878。结论2D-SWE作为一种无创性检查方法,对AILD病人肝纤维化的诊断与肝组织穿刺病理诊断具有较好的一致性和准确性。

Objective To investigate the value of two-dimensional shear wave elastography(2D-SWE)in assessing the degree of liver fibrosis in patients with autoimmune liver disease(AILD).Methods A total of 66 AILD patients who attended our hospital were enrolled,and 2D-SWE examination and liver biopsy were performed for all patients.Based on the pathological results of liver biopsy,the patients were divided into liver fibrosis group and control group,and elastic modulus value(EMV)was compared between the two groups and the patients with different pathological stages of liver fibrosis.The receiver operating characteristic(ROC)curve was used to analyze the clinical value of 2D-SWE in predicting the degree of liver fibrosis in patients with AILD.[WTHX]ResultsThe liver fibrosis group had a significantly higher EMV of the liver than the control group(t=4.470,P<0.001),and there was a significant difference in EMV between the patients with different pathological stages of liver fibrosis(F=17.570,P<0.001).EMV of the liver was positively correlated with the histological stage of liver fibrosis in patients with AILD(r=0.987,P<0.001).Liver EMV measured by 2D-SWE showed a sensitivity of 78.4%,a specificity of 86.7%,a missed diagnosis rate of 21.6%,and a misdiagnosis rate of 13.3%in the diagnosis of liver fibrosis,with an area under the ROC curve of 0.878.ConclusionAs a noninvasive method,2D-SWE has good consistency and accuracy with the pathological results of liver biopsy in the diagnosis of liver fibrosis in patients with AILD.