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华西医学  2015 

超声实时组织弹性成像评价乙型肝炎肝纤维化

DOI: 10.7507/1002-0179.20150476, PP. 1671-1674

Keywords: 超声检查,实时组织弹性成像,慢性乙型肝炎,肝纤维化

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Abstract:

目的?探讨超声实时组织弹性成像(RTE)中的组织弥散定量参数判定乙型肝炎不同程度肝纤维化的价值。方法?2012年7月-2014年11月期间,以肝穿刺活体组织检查(活检)病理结果为金标准,对112例乙型肝炎患者行RTE检查得到弹性图像,并进行组织弥散定量分析,获得右肝实质的肝脏纤维化指数(LFI)值,然后将LFI值与肝穿刺活检病理结果的纤维化分期对照,采用单因素方差分析对不同程度肝纤维化的LFI值进行比较,组间存在差异者再用最小显著差值法进行组间两两比较,最后用受试者工作特征(ROC)曲线确定诊断不同程度肝纤维化LFI值的临界值。结果?慢性肝病肝纤维化分为S0、S1、S2、S3、S4期的LFI值分别为2.36±0.46、2.38±0.45、2.84±0.54、3.16±0.59、3.69±0.55,不同程度肝纤维化组间的LFI值差异有统计学意义(F=29.959,P<0.001),S0、S1组间差异无统计学意义(P=0.920),S2、S3期组间差异无统计学意义(P=0.076),其余各组间差异均有统计学意义(P<0.05)。区分S0~S1期与S2~S3期、S2~S3期与S4期ROC曲线下面积分别为0.784、0.799,其LFI值的临界值分别为2.83、3.69。结论?RTE是无创评价乙型肝炎肝纤维化的可行方法,LFI值对区分肝纤维化的程度具有较好的诊断价值。

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