声脉冲辐射力成像与肝纤维化积分在肝纤维化家兔模型中的实验研究

发布时间：2018-08-11 10:43

【摘要】：目的探讨声脉冲辐射力成像技术(ARFI)与肝纤维化积分(FibroScore,由结合珠蛋白、γ-谷氨酰转肽酶和血小板计数3项指标构成的肝纤维化无创性预测模型)评价家兔肝纤维化的价值。 方法应用硫代乙酰胺(TAA)对32只家兔以皮下注射的方法建立肝纤维化模型,8只家兔作为对照组。于首次注射后第4,8,12周分批进行声脉冲辐射力成像检查,获取反映肝剪切波速度的声触诊组织量化值(shear wave velocity, Vs),并计算FibroScore。随后处死家兔,取其肝脏行病理学分析。计量资料(偏态)用中位数(四分位间距)表示；采用Spearman相关分析检验FibroScore、Vs与肝纤维化病理分级间的相关性,采用多组间秩和检验检测不同肝纤维化组间的FibroScore、Vs的差别并用最小显著差异法进一步行两两比较,对FibroScore和Vs的诊断效率行受试者工作特征(ROC)曲线分析。以病理检查结果为金标准,比较分析声触诊组织量化值和FibroScore对家兔肝纤维化分期的诊断价值。 结果29只家兔造模成功,其中肝纤维化分期为S1、S2、S3和S4期的分别有10、8、7和4只。声触诊组织量化值和FibroScore均随纤维化程度的增加而增大,各组间差异均有统计学意义(P＜0.05)。Vs判别显著纤维化(S≥2)、严重纤维化(S≥3)、肝硬化(S=4)和任何程度纤维化(S≥1)的曲线下面积(AUC)分别为0.87、0.82、0.89、0.92,准确率分别为84%、73%、75%和87%。FibroScore判别显著纤维化(S≥2)、严重纤维化(S≥3)、肝硬化(S=4)和任何程度纤维化(S≥1)的曲线下面积(AUC)分别为0.86、0.79、0.82、0.84,准确率分别为81%、66%、70%和83%。 结论ARFI与FibroScore均能较准确预测显著肝纤维化,ARFI具有更高的预测价值,二者联合应用可以提高诊断率。
[Abstract]:Objective to evaluate the value of acoustic pulse radiography (ARFI) and hepatic fibrosis score (FibroScore, a noninvasive predictive model of hepatic fibrosis in rabbits, which consists of three indexes: binding globin, 纬 -glutamyl transpeptidase and platelet count). Methods Hepatic fibrosis model was established by subcutaneous injection of thioacetamide (TAA) in 32 rabbits as control group. Acoustic pulse radiography was performed in batches at 812 weeks after the first injection to obtain the quantitative value of acoustic palpation tissue (shear wave velocity, Vs),) which reflected the velocity of liver shear wave and to calculate FibroScore. Then the rabbits were killed and their liver was taken for pathological analysis. The quantitative data (skewness) were expressed as median (quartile spacing), and the correlation between FibroScoreus Vs and pathological grade of hepatic fibrosis was examined by Spearman correlation analysis. Multigroup rank sum test was used to detect the difference of FibroScoreVs in different liver fibrosis groups and the least significant difference method was used to further compare them. The diagnostic efficiency of FibroScore and Vs was analyzed by (ROC) curve. The quantitative value of acoustic palpation and FibroScore in the diagnosis of hepatic fibrosis stage in rabbits were compared and analyzed according to the results of pathological examination as gold standard. Results the models of 29 rabbits were successfully established, of which there were 10 7 and 4 hepatic fibrosis stages in S _ (1) S _ (2) S _ (2) S _ (3) and S _ (4), respectively. The quantitative value of acoustic palpation tissue and FibroScore increased with the increase of fibrosis degree. There were significant differences among the three groups (P < 0. 05). Vs discriminating marked fibrosis (S 鈮，

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