实时组织弹性成像评价大鼠免疫性肝炎肝纤维化程度的实验研究

发布时间：2018-01-05 10:26

  本文关键词：实时组织弹性成像评价大鼠免疫性肝炎肝纤维化程度的实验研究　出处：《山西医科大学》2016年硕士论文　论文类型：学位论文

  更多相关文章： 超声检查 弹性成像 免疫性肝炎 纤维化 炎症

【摘要】：目的:1.探讨弹性参数评价大鼠免疫性肝炎肝纤维化分期的可行性。2.探讨炎症分级对弹性参数评价大鼠免疫性肝炎肝纤维化分期的影响。方法:60只SD雄性大鼠随机分为正常对照组和实验组,正常对照组8只,实验组52只。实验组尾静脉注射猪血清诱导免疫性肝炎,正常对照组尾静脉注射生理盐水。每隔两周从实验组与对照组随机选取大鼠进行实时组织弹性成像(real-time tissue elastography,RTE)检查,取得12个弹性参数,包括应变均值(MEAN)、标准偏差(SD)、蓝色区域%(%AREA)、复杂度(COMP)、峰度(KURT)、偏度(SKEW)、对比度(CONT)、均等性(ENT)、杂乱度(IDM)、一致性(ASM)、相关性(CORR)及肝纤维化指数(LF Index)。随后处死大鼠,取肝组织进行Masson及HE染色,并根据肝纤维化分期(Masson染色)及炎症分级(HE染色)将实验组大鼠分别分为S0~S4组和G0~G4组。组间比较采用Kruskal-Wallis检验,相关分析采用Spearman秩相关分析,构建受试者工作(receiver operating characteristic,ROC)曲线,取得截断值并且评价LF Index诊断效能。结果:除了COMP、KURT及CORR,其余9个弹性参数组间比较差异有统计学意义(P0.05),其中肝纤维化分期和LF Index相关性最高(r=0.809,P0.05)。除了KURT和CORR,其余10个弹性参数组间比较差异统计学意义(P0.05),其中肝炎症分级和LF Index相关性最高(r=0.766,P0.05)。以LF Index绘制肝纤维化分期ROC曲线,S≥S1曲线下面积为0.940,截断值为2.35,敏感度为97.1%,特异度为73.3%;S≥S2曲线下面积为0.865,截断值为2.99,敏感度为78.6%,特异度为81.0%;S≥S3曲线下面积为0.924,截断值为3.48,敏感度为94.4%,特异度为87.1%;S=S4曲线下面积为0.933,截断值为4.05,敏感度为87.5%,特异度为95.1%。LF Index可以有效地评价肝纤维化分期,其准确性为79.6%(39/49)。但是,有20.4%(10/49)的结果为假阳性。结论:弹性参数可以有效地评价大鼠免疫性肝炎肝纤维化分期。但是,炎症坏死活动作为重要的粘性因素会影响其准确性。
[Abstract]:Objective : To evaluate the feasibility of evaluating the stage of liver fibrosis in rats with immune hepatitis by elastic parameters . Methods : 60 SD male rats were randomly divided into normal control group and experimental group . Results : In addition to COMP , KURT and CORR , there was a significant difference among the remaining nine groups ( P0.05 ) , among which the correlation between the stage of liver fibrosis and LF index was the highest ( r = 0.809 , P0.05 ) . In addition to the KURT and CORR , the difference was statistically significant among the remaining 10 elastic parameters ( P0.05 ) , among which the correlation between liver inflammation grade and LF index was the highest ( r = 0.766 , P0.05 ) . The ROC curve of hepatic fibrosis was drawn with LF Index , the area of S 鈮，

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