声辐射力脉冲成像技术术前评估胆道闭锁患儿肝硬化

发布时间：2018-01-15 01:34

本文关键词：声辐射力脉冲成像技术术前评估胆道闭锁患儿肝硬化　出处：《中国医学影像技术》2017年10期 　论文类型：期刊论文

【摘要】：目的探讨声辐射力脉冲(ARFI)成像技术术前评估胆道闭锁患儿肝硬化的价值。方法选取64例经胆道造影检查确诊的胆道闭锁患儿,于Kasai手术前3天内行ARFI检查,并在术中行肝组织活检,根据活检病理结果分为肝硬化组和非肝硬化组。于声触诊组织量化模式下测定肝脏剪切波速度(SWS)值,比较2组间SWS值的差异,并绘制ROC曲线,评价SWS值术前诊断胆道闭锁患儿肝硬化的价值。结果64例胆道闭锁患儿中,肝硬化组8例,SWS值为(2.51±0.50)m/s;非肝硬化组56例,SWS值为(1.74±0.31)m/s,肝硬化组SWS值明显高于非肝硬化组(t=6.039,P0.001)。ROC曲线分析显示ARFI技术诊断肝硬化的最佳临界值为2.16m/s,曲线下面积为0.930(P0.001),诊断敏感度、特异度分别为87.50%、92.86%。结论 ARFI成像技术在无创评价预测胆道闭锁患儿术前肝硬化中有一定的价值,可为临床选择治疗方案和判断疾病预后提供指导信息。
[Abstract]:Objective to evaluate the value of acoustic radiation power pulse array imaging (ARFI) in preoperative assessment of biliary atresia in children with liver cirrhosis. Methods 64 cases of children with biliary atresia diagnosed by cholangiography were selected. ARFI was performed within 3 days before Kasai operation and liver biopsy was performed during the operation. According to the pathological results of biopsy, the liver shear wave velocities were measured in the quantitative mode of acoustic palpation. The difference of SWS between the two groups was compared, and the ROC curves were plotted. Results in 64 children with biliary atresia, 8 patients with cirrhosis had a SWS value of 2.51 卤0.50m / s; The SWS value of 56 cases of non-cirrhosis group was 1.74 卤0.31 m / s, and the SWS value of cirrhosis group was significantly higher than that of non-cirrhosis group (6.039). The analysis of P 0.001g 路ROC curve showed that the best critical value of ARFI technique for the diagnosis of cirrhosis was 2.16 m / s, and the area under the curve was 0.930 m 路ROC. The specificity was 87.50% and 92.86% respectively. Conclusion ARFI imaging is valuable in predicting preoperative cirrhosis in children with biliary atresia. It can provide guiding information for clinical choice of treatment and judgment of disease prognosis.
【作者单位】：上海交通大学医学院附属新华医院超声科;上海交通大学医学院附属新华医院病理科;
【基金】：上海申康医院发展中心临床科技创新项目(SHDC22015007) 上海新华医院院基金项目(13YJ24)
【分类号】：R445.1;R726.5
【正文快照】： 胆道闭锁是发生于婴儿时期的少见疾病,发病率约为活产儿的1/8　000~1/15　000,表现为进行性破坏性胆道炎症性病变,使肝内外胆道不同程度的纤维化狭窄或闭锁,最终导致肝硬化[1-2]。术前准确预测胆道闭锁患儿是否存在肝硬化是临床选择治疗方案和判断预后的关键。声辐射力脉冲(ac

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