Ultrasound elastographic techniques in focal liver lesions

Elastographic techniques are new ultrasound-based imaging techniques developed to estimate tissue deformability/stiffness. Several ultrasound elastographic approaches have been developed, such as static elastography, transient elastography and acoustic radiation force imaging methods, which include point shear wave and shear wave imaging elastography. The application of these methods in clinical practice aims at estimating the mechanical tissues properties. One of the main settings for the application of these tools has been liver stiffness assessment in chronic liver disease, which has been studied mainly using transient elastography. Another field of application for these techniques is the assessment of focal lesions, detected by ultrasound in organs such as pancreas, prostate, breast, thyroid, lymph nodes. Considering the frequency and importance of the detection of focal liver lesions through routine ultrasound, some studies have also aimed to assess the role that elestography can play in studying the stiffness of different types of liver lesions, in order to predict their nature and thus offer valuable non-invasive methods for the diagnosis of liver masses.

GPR参数模型联合Fibroscan对慢性乙型肝炎肝纤维化的诊断效能

目的 评估GPR参数模型联合Fibroscan对慢性乙型肝炎(CHB)肝纤维化中的的诊断效能。方法 选择2015年1月至2020年12月淮安市第四人民医院收治的患者161例。穿刺前1周内检测Fibroscan(LSM值)以及γ-谷氨酰转肽酶(GGT)、血小板(PLT)计数,并计算GGT/PLT比值(GPR)指数。分析GPR、LSM值与肝纤维化程度的相关性;分析GPR参数模型联合Fibroscan对CHB肝纤维化诊断的准确性。结果 CHB患者F0-F4期LSM值分别为(5.06±1.48)、(5.65±1.48)、(6.29±1.14)、(8.65±2.75)、(14.03±4.24)kPa,差异有统计学意义(F=64.327,P<0.01);与病理肝纤维化分期呈正相关(r=0.730,P<0.01)。F0-F4期GPR值分别为0.32±0.22、0.46±0.40、0.57±0.50、0.80±0.72、1.20±1.06,差异有统计学意义(F=4.921,P<0.01),与病理肝纤维化分期呈正相关(r=0.384,P<0.05)。当以F≥2为分割点进行分组,单独LSM、GPR值和LSM+GPR联合的ROC曲线下面积分别为0.851、0.711、0.862;F≥3时,单独LSM、GPR值和LSM+GPR联合的ROC曲线下面积分别为0.899、0.722、0.911;F=4时,单独LSM、GPR值和LSM+GPR联合的ROC曲线下面积分别为0.921、0.711、0.926。结论 LSM+GPR联合诊断肝纤维化的能力均高于单独的LSM、GPR值,GPR参数模型联合Fibroscan可提高慢性乙型肝炎肝纤维化诊断效能。