ARFI与S指数评价兔肝纤维化的实验研究

发布时间：2018-04-29 16:17

  本文选题：声辐射力脉冲成像 + S指数　； 参考：《兰州大学》2014年硕士论文

【摘要】：目的评价声辐射力脉冲成像(ARFI)技术与血清肝纤维化诊断模型S指数单独及联合应用在家兔肝纤维化诊断中的价值。 方法40只家兔随机分为实验组(32只)和对照组(8只),实验组经颈部皮下注射5%硫代乙酰胺(TAA)制作肝纤维化模型,首剂1.5ml/kg,以后每次1ml/kg,每周2次；对照组经颈部皮下注射同等剂量的生理盐水。于造模后第4、8、12周末分别随机从实验组中取8-10只、对照组中取2-3只家兔进行声辐射力脉冲成像检查,记录肝脏剪切波速度(shear wave velocity, SWV),并抽取兔耳缘静脉血4ml行血清生化检查和血小板计数,计算S指数,随后处死家兔,取其肝脏制作标本行组织病理学检查,采用受试者工作特征(ROC)曲线评价ARFI、S指数单项及联合应用对肝纤维程度的诊断价值。 结果29只家兔造模成功,肝纤维化分期S1-S4期者分别有10只、8只、7只、4只；3只家兔肝脏严重炎症坏死而无纤维化。37只家兔均成功完成ARFI检测。肝纤维化分期SWV和S指数的诊断界值分别为S1期SWV1.32m/s, S指数0.02；S2期SWV1.62m/s, S指数0.04；S3期SWV1.96m/s, S指数0.11；S4期SWV2.04m/s, S指数1.84,SWV和S指数均随着肝纤维化程度的增加而增大,各期测值均有统计学意义(P0.05)。SWV与S指数均与肝纤维化病理分期存在相关,相关系数分别为0.724和0.472(P0.001)。ARFI与S指数诊断家兔肝纤维化S≥S2期的ROC曲线下面积为0.868、0.753；S≥S3期的ROC曲线下面积为0.822、0.706；S=S4期的ROC曲线下面积为0.886、0.735。ARFI联合S指数诊断肝纤维化S≥S3期的ROC曲线下面积为0.864,大于单独ARFI或S指数诊断。 结论1.采用TAA皮下注射的方法能够成功获得兔肝纤维化模型：2.ARFI与S指数均可用于肝纤维化的无创诊断,ARFI较S指数能更准确的定量诊断肝纤维化分期,二者联合有助于提高对显著肝纤维化诊断的准确性。
[Abstract]:Objective to evaluate the diagnostic value of acoustic radiation power pulse imaging (ARFI) technique and serum hepatic fibrosis model S index in the diagnosis of hepatic fibrosis in rabbits. Methods Forty rabbits were randomly divided into experimental group (n = 32) and control group (n = 8). The experimental group was injected subcutaneously with 5% thioacetamide (TAA) to make hepatic fibrosis model. The control group was subcutaneously injected with the same dose of normal saline through the neck. 8-10 rabbits were randomly selected from the experimental group at the end of 812 weeks after modeling, and 2-3 rabbits from the control group were examined by acoustic radiation pulse imaging. The shear wave velocity of the liver was recorded, and the blood 4ml of the rabbit auricular vein was extracted for serum biochemical examination and platelet count, then the S index was calculated. Then the rabbits were killed and their liver specimens were taken for histopathological examination. The diagnostic value of ARFI S index single item and combined application in liver fiber degree was evaluated by using the operating characteristics of the subjects (ROC) curve. Results the model of 29 rabbits was successfully established, and ARFI was detected successfully in 10, 8, 7, 4, 3, 3 and 37 non-fibrotic rabbits in the S1-S4 stage of hepatic fibrosis, respectively. The diagnostic cutoff values of SWV and S index in hepatic fibrosis stage were SWV 1.32 m / s in S1 stage, SWV 1.62 m / s in S index 0.02 and S2 stage, SWV 1.96 mr / s in S index 0.04 and S3 phase, SWV 2.04m / s in S index 0.11 and S4 stage, S index 1.84SWV and S index increased with the increase of liver fibrosis. There was a significant correlation between P0.05, SWV and S index and the pathological stage of hepatic fibrosis. Correlation coefficient was 0.724 and 0.472(P0.001).ARFI and S index were used to diagnose the area under the ROC curve of S 鈮，

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