摘要
目的：探讨声脉冲辐射力成像（ARFI）技术在原发性胆汁性肝硬化（PBC）临床分期诊断中的应用价值。方法：分别对58例PBC患者和30例健康对照者应用ARFI技术进行肝脏弹性的检测，所有PBC患者均经肝穿刺活检获得病理组织学诊断，以病理结果为金标准，对肝脏的ARFI弹性测值进行统计分析。结果：PBC组ARFI测值为（2.05±0.70） m/s，对照组为（1.02±0.18） m/s，两组间测值差异存在显著统计学意义（P<0.01）。PBC按病理组织学分期，各期的ARFI平均值分别为Ⅰ期（1.64±0.58） m/s（n=16），Ⅱ期（1.83±0.53） m/s（n=19），Ⅲ期（2.37±0.65） m/s（n=13）和Ⅳ期（2.68±0.67） m/s（n=10），组间比较差异具有显著统计学意义（P＜0.01)。PBC患者肝脏ARFI测值与组织学分期存在相关，相关系数为0.57（P＜0.01）。ARFI技术诊断PBC患者肝硬化期的ROC曲线下面积为0.81。结论：ARFI技术可较准确对PBC进行无创定量分期诊断，具有良好的临床应用前景。
Abstract
Objective: To investigate the clinical diagnostic value of the acoustic radiation force impulse (ARFI) technique in the quantitative evaluation of primary biliary cirrhosis(PBC). Methods: Fifty eight patients with PBC and 30 normal healthy controls were examined using ARFI technique. ARFI was compared by correlation with liver pathological grades in PBC. Referring to the histological stage on liver biopsy, the ARFI value was assessed by using receiver operating characteristic(ROC) curve analysis. Results: The parameter of ARFI was significantly higher in PBC group((2.05±0.70) m/s) than that in control group((1.02±0.18) m/s, P<0.01). The liver stiffness at ARFI sono-elastography were (1.64±0.58)m/s for the patients with group Ⅰ, (1.83±0.53) m/s for those with group Ⅱ, (2.37±0.65) m/s for those with group Ⅲ, and (2.68±0.67) m/s for those with group Ⅳ, respectively. This results showed that the ARFI values were significantly different(P＜0.01) among the different stages of PBC. A positive correlation was found between the stiffness of the liver and the pathological grade of PBC(r=0.57, P<0.01). The ARFI cut-off that best distinguished group of cirrhosis from patients with PBC was 2.05 m/s(accuracy: AUC=0.81). Conclusion: ARFI technique not only can examine the stiffness of the liver noninvasively, but also has potentially valuable for quantitative evaluating the degree of PBC.
关键词
肝硬化 /
胆汁性 /
超声检查 /
多普勒 /
脉冲
Key words
Liver cirrhosis /
biliary /
Ultrasonography /
Doppler /
pulsed
张大鹍;赵媛媛;陈 敏;刘 阳;李 猛;周一鸣;赵红伟.
声脉冲辐射力成像在原发性胆汁性肝硬化定量诊断中的应用研究[J]. 中国临床医学影像杂志. 2014, 25(4): 248-251
ZHANG Da-kun;ZHAO Yuan-yuan;CHEN Min;LIU Yang;LI Meng;ZHOU Yi-ming;ZHAO Hong-wei.
The initial clinical study of acoustic radiation force impulse imaging in quantitative evaluatingthe degree of primary biliary cirrhosis[J]. Journal of China Clinic Medical Imaging. 2014, 25(4): 248-251
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