超声实时弹性特征量评价非酒精性脂肪肝纤维化的临床价值研究

发布时间：2018-04-16 09:06

本文选题：非酒精性脂肪肝 + 肝纤维化　；参考：《新疆医科大学》2014年硕士论文

【摘要】：目的：探讨超声实时弹性特征量技术评价非酒精性脂肪肝纤维化的诊断价值。方法：选择经常规超声检查和临床共同诊断为非酒精性脂肪肝的患者46例。年龄18-74岁,平均年龄40.0±6.7岁。使用日本HitachiHV-900型彩色超声诊断仪,常规彩超探头为腹部凸阵探头,频率1MHz-5MHz;弹性成像使用探头为L-52,频率3MHz-7MHz。首先使用腹部凸阵探头对研究对象进行常规彩超检查,随即更换为L-52探头并设置为肝脏弹性成像条件。选取与肝脏穿刺活检相近的区域来获取稳定的弹性图并启动弹性特征量分析软件,记录仪器自动生成12个弹性特征量参数。统计学方法使用多个独立样本比较的秩和检验判断5组间12个特征量参数的差异；用Spearman多元相关分析判断5组间12个定量参数与病理分期间的相关性；用受试者工作特征曲线(ROC.曲线)判断相关性较好的参数对诊断肝纤维化分期的准确性并得出区分肝纤维化分期的截断值。结果：5组病例间,除相关性(CORR)外,其余11个特征量参数差异均有统计学意义(P0.05)；除峰度(KURT)外其余11个特征量参数与肝纤维化的病理分期之间有良好的相关性(P0.05)。MEAN、%AREA、LF在SSO、SS1、SS2、SS3时ROC曲线下面积分别为0.832、0.838、0.869、0.865(MEAN);0.830、0.838、0.861、0.831(%AREA);0.813、0.827、0.849、0.820(LF)。MEAN、%AREA、LF在区分SS0、SS1、SS2时的截断值分别为104.05、88.30、85.15(MEAN);31.72、39.02、41.74(%AREA);3.00、3.26、3.91(LF)。结论：1.超声实时弹性成像特征量技术用于肝纤维化的无创性诊断是可行的。2.超声实时弹性成像特征量技术有助于评估肝纤维化的分期。3.实时弹性成像特征量参数MEAN、%AREA及LF对肝纤维化分期的诊断有一定价值。
[Abstract]:Objective: to evaluate the diagnostic value of ultrasonic real-time elastic characteristic technique for non-alcoholic fatty liver fibrosis.Methods: 46 patients with non-alcoholic fatty liver diagnosed by conventional ultrasonography and clinical diagnosis were selected.The average age was 40.0 卤6.7 years.HitachiHV-900 color ultrasound diagnostic instrument was used in Japan, the conventional color ultrasound probe was abdominal convex array probe, the frequency was 1MHz-5MHz, and the elastic imaging was L-52 with 3MHz-7MHz.Firstly, conventional color Doppler ultrasound was used to examine the subjects with abdominal convex array probe, then the L-52 probe was replaced and the condition of liver elastic imaging was set.The area close to the liver biopsy was selected to obtain the stable elastic graph and the software of elastic eigenvalue analysis was started. The instrument automatically generated 12 parameters of the elastic eigenvalue.Statistical method was used to judge the difference of 12 characteristic parameters among 5 groups by rank sum test compared with many independent samples, the correlation between 12 quantitative parameters and pathological stages in 5 groups was judged by Spearman multivariate correlation analysis, and the operating characteristic curve of subjects was used to estimate the correlation between 12 quantitative parameters and pathological stages.Curve) to judge the accuracy of the relevant parameters in the diagnosis of hepatic fibrosis staging and to obtain the cut-off value for differentiating the hepatic fibrosis stages.Results among the 5 groups of cases, except Corr,The truncation values were 104.05 ~ 88.30 ~ 85.15 ~ 39.72 ~ 39.02 ~ 41.74 ~ 3.00 ~ 3.263.263.91 / L ~ (-1) / L ~ (-1), respectively.Conclusion 1.It is feasible to use the real-time elastography characteristic quantity technique in the non-invasive diagnosis of hepatic fibrosis.Ultrasound real-time elastography is helpful in assessing the staging of hepatic fibrosis. 3. 3.Real-time elastic imaging parameters such as arms and LF are valuable in the diagnosis of hepatic fibrosis stage.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R445.1

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