实时剪切波弹性成像对慢性乙型病毒性肝炎患者肝纤维化隐匿进展的临床应用研究

发布时间：2018-05-20 14:25

  本文选题：实时剪切波弹性成像 + 肝纤维化　； 参考：《宁波大学》2017年硕士论文

【摘要】：目的探讨实时剪切波弹性成像技术(real-time shear wave elastography,SWE)无创定量评价CHB患者隐匿进展性肝纤维化程度的临床价值。方法选取来我院就诊临床确诊为CHB患者827例,常规经过血液学、SWE与肝穿刺活检病理学检查,血液学检查ALT、AST低于检测下限及影像学检查正常为实验组,ALT、AST和(或)影像学检查异常为对照组,以病理结果为金标准,对肝脏弹性模量值与实验组和对照组CHB患者肝纤维化程度的相关性进行分析。结果827例CHB患者中实验组644例,对照组183例。CHB患者在不同肝纤维化分期组间性别比例无差别,而年龄、肝脏弹性模量值差别都具有统计学意义。肝脏弹性模量值与实验组CHB患者肝纤维化程度呈正相关,Spearman相关系数为0.665,P=0.000。SWE技术诊断实验组CHB患者进展性肝纤维化程度S≥3期阈值为7.96Kpa,特异度80.2%,灵敏度为83.5%,曲线下面积为0.889;诊断对照组CHB患者进展性肝纤维化程度S≥3期阈值为8.59Kpa,特异度70%,灵敏度为75.9%,曲线下面积为0.856。两位医师用SWE检测不同纤维化分期CHB患者的组间及组内重复性良好,S0~S4各分期组间相关系数为0.901、0.917、0.945、0.979、0.891。结论1.SWE技术诊断ALT和AST低于检测下限、影像学检查正常的实验组CHB患者肝纤维化程度≥S3期曲线下面积为0.889,表明SWE技术对ALT和AST低于检测下限、影像学检查正常CHB患者具有较高的诊断效能,且能为临床提供准确的客观依据,可无创定量评价CHB患者隐匿进展性肝纤维化程度。2.肝功能转氨酶指标AST、ALT会对SWE技术测量肝脏弹性模量值产生影响。
[Abstract]:Objective to evaluate the clinical value of real-time shear wave elastography (SWE) in noninvasive quantitative evaluation of occult progressive hepatic fibrosis in patients with CHB. Methods 827 patients with CHB were selected and examined by hematology and liver biopsy. Hematological examination of alt was lower than the lower detection limit and normal imaging examination was the control group with abnormal alt AST and / or imaging examination, and the pathological results were regarded as the gold standard. The relationship between the elastic modulus of liver and the degree of hepatic fibrosis in CHB patients was analyzed. Results there were 644 cases in the experimental group and 183 cases in the control group in 827 patients with CHB. There was no difference in sex ratio among the groups with different stages of hepatic fibrosis, but the difference of age and modulus of elasticity of liver was statistically significant. There was a positive correlation between liver modulus of elasticity and the degree of hepatic fibrosis in experimental group CHB patients. The correlation coefficient of Spearman correlation coefficient was 0.665P ~ (0.000.SWE) for the diagnosis of progressive hepatic fibrosis in CHB patients in experimental group. The threshold value of S 鈮，

本文编号：1914971