VTQ技术诊断早期肝硬化的初步研究

发布时间：2018-02-03 01:17

本文关键词： 肝硬化声触诊组织量化技术剪切波速度肝脏纤维化　出处：《吉林大学》2014年硕士论文　论文类型：学位论文

【摘要】：目的：通过声触诊组织量化（virtual touch tissue quantification, VTQ）技术研究早期肝硬化的组织硬度变化，探讨早期肝硬化肝脏左、右叶的弹性指数变化是否一致。寻找最能反映早期肝硬化肝脏组织弹性的部位，提高超声影像诊断对早期肝硬化的诊断水平，并为早期肝硬化的确诊及临床治疗提供可靠的影像学依据，进一步提高超声检查在弥漫性肝病特别是早期肝硬化中的应用价值。方法：根据Scheuer标准，选择2012年9月至2013年12月间就诊于吉林大学第二医院并均经肝穿刺活检肝纤维化S4期的51例早期肝硬化患者（男32名，女19名），平均年龄(46.41±1.42)岁。正常对照组50例（男29名，女21名），平均年龄(43.12±1.07)岁，入选标准为无肝、肾、心、脑疾病，肝、肾功能正常，肝炎病毒标志物阴性。应用ACUSON S2000彩色多普勒超声诊断仪，利用声触诊组织量化技术对两组患者分别测量肝左、右叶的剪切波速度（VTQ）。数据分析：采用SPPS17.0统计分析软件，计量资料以均数±标准差（x±S）表示。两组肝脏左、右叶之间VTQ参考值分别采用配对样本t检验，比较差异有无统计学意义。两组间计量资料采用独立样本t检验，P0.05有统计学意义。结果： 1.正常对照组肝脏左、右叶VTQ参考值分别为（1.22±0.066）m/s（、1.21±0.056）m/s，对比分析肝脏左、右叶VTQ值无统计学意义（p0.05） 2.早期肝硬化肝脏左叶组VTQ参考值为（2.79±0.207）m/s，右叶组VTQ参考值为（2.33±0.196）m/s，比较早期肝硬化肝脏左、右叶VTQ值有统计学意义（p0.05）。肝左叶组和右叶组VTQ值都呈升高趋势，但右叶组标准差低于左叶组。 3.正常对照组肝脏VTQ参考值为（1.21±0.056）m/s，早期肝硬化组VTQ参考值为（2.33±0.196）m/s，对早期肝硬化组及正常对照组的VTQ值进行独立样本t检验，差异有显著统计学意义（t=37.52,p0.001）。结论: 1.正常人肝脏左、右叶VTQ值无明显差异。 2.早期肝硬化患者肝脏左、右叶VTQ值差异较明显。早期肝硬化患者肝左叶VTQ值均比右叶VTQ值高，，但肝右叶VTQ的准确性、稳定性明显高于左叶。提示在早期肝硬化阶段，测量右叶VTQ值更能准确地反映出肝脏纤维化程度。 3.本研究测定了早期肝硬化组肝左、右叶的VTQ值，与正常对照组比较发现：早期肝硬化组肝脏组织硬度具有显著变化，这对早期肝硬化的诊断具有显著的临床指导意义。 4.声触诊组织量化技术能无创测定肝脏纤维化程度，是诊断早期肝硬化的一种有效方法，拓展了超声在估测肝纤维化程度中的应用。该技术简单、无创，特异性较强，灵敏度较高，适合作为检查肝脏的常规检查。
[Abstract]:Objective: The changes of tissue hardness in early cirrhosis were studied by acoustic palpation and virtual touch tissue quantification (VTQQ) technique. To investigate whether the elastic index of the left and right lobes of liver in early cirrhosis is the same, to find the best location to reflect the elasticity of liver tissue in early liver cirrhosis, and to improve the diagnostic level of early cirrhosis by ultrasound imaging. It also provides reliable imaging basis for the diagnosis and clinical treatment of early liver cirrhosis, and further improves the value of ultrasonography in the application of diffuse liver disease, especially early cirrhosis. Methods: According to Scheuer standards. From September 2012 to December 2013, 51 patients (32 males and 19 females) with liver fibrosis stage S4 (male 32 and female 19) were selected from the second Hospital of Jilin University and underwent liver biopsy. The mean age was 46.41 卤1.42 years, and 50 normal controls (male 29, female 21, mean age 43.12 卤1.07). Brain diseases, normal liver and kidney function, and negative markers of hepatitis virus. The left liver of the two groups was measured by ACUSON S2000 color Doppler ultrasound diagnostic instrument and tissue quantification technique of acoustic palpation. The shear wave velocity of the right lobe was measured by VTQ. Data analysis: SPPS17.0 statistical analysis software was used. The measured data were expressed as mean 卤standard deviation (x 卤S). The two groups were left liver. The VTQ reference values between the right lobe and the right lobe were tested by paired sample t-test, the difference was statistically significant, and the measurement data between the two groups were statistically significant with independent sample t-test (P0.05). Results: 1. The reference values of VTQ in the left and right lobes of the normal control group were 1.22 卤0.066 m / s and 1.21 卤0.056 m / s, respectively. The VTQ value of right lobe was not statistically significant (p0.05). 2.The VTQ reference value of early cirrhosis liver Zuo Ye group was 2.79 卤0.207 m / s, and the VTQ reference value of right lobe group was 2.33 卤0.196 m / s. The VTQ values of left and right lobes were significantly higher in early liver cirrhosis than those in early liver cirrhosis. The VTQ values in Zuo Ye group and right lobe group were increased, but the standard deviation in right lobe group was lower than that in Zuo Ye group. 3. The reference value of VTQ in normal control group was 1.21 卤0.056 m / s, and that in early cirrhosis group was 2.33 卤0.196 m / s. The VTQ values of early cirrhosis group and normal control group were tested by independent t-test, and the difference was statistically significant (37.52%, P 0.001). Conclusion: 1. There was no significant difference in VTQ values between the left and right lobes of the normal liver. 2. The VTQ values of left and right lobes of liver were significantly different in patients with early liver cirrhosis. The VTQ value of Zuo Ye was higher than that of VTQ in right lobe of liver in early cirrhosis patients, but the accuracy of VTQ in right lobe of liver. The stability was significantly higher than that of Zuo Ye, suggesting that the VTQ value of right lobe could accurately reflect the degree of hepatic fibrosis in early stage of liver cirrhosis. 3. The VTQ values of left and right lobes of liver in early cirrhosis group were measured. Compared with normal control group, the hardness of liver tissue in early cirrhosis group was significantly changed. It has significant clinical significance in the diagnosis of early cirrhosis. 4. The quantitative technique of acoustic palpation can be used to detect the degree of liver fibrosis. It is an effective method for the diagnosis of early liver cirrhosis. It expands the application of ultrasound in estimating the degree of liver fibrosis. This technique is simple and non-invasive. It is suitable for routine examination of liver because of its strong specificity and high sensitivity.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R575.2

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