实时二维剪切波弹性成像评价急性肝衰竭大鼠肝脏硬度

目的 探讨实时二维剪切波弹性成像（2D-SWE）对于检测大鼠急性肝衰竭（ALF）和指导预防性用药治疗的应用价值。方法 将28只雄性SD大鼠分为4组，即对照组（8只）、模型组（8只）、乳果糖组（6只）和美常安组（6只）。实验第1~8天，对美常安组予以美常安稀释后灌胃，乳果糖组予以乳果糖灌胃，对照组和模型组予以等量生理盐水。实验第6、7天，对模型组、乳果糖组和美常安组大鼠均腹腔注射硫代乙酰胺，对照组注射生理盐水。实验第8天，采用2D-SWE技术测量4组大鼠肝脏硬度值（LSM）。构建ROC曲线，根据AUC选出准确率最高的LSM进行组间比较。实验第9天，取大鼠肝组织行病理检查。结果 模型组主要病理表现为炎症、坏死；美常安组及乳果糖组炎症坏死程度较模型组减轻；对照组表现为正常肝组织。根据模型组LSM构建的ROC曲线中，平均值诊断效能最佳；以8.44 kPa为截断值，其AUC、敏感度和特异度分别为0.768、100%和62.50%。模型组LSM较其他3组明显升高（P均<0.05）。结论 ALF大鼠LSM增高。2D-SWE对检测ALF及预防性用药后疗效评估具有一定价值。

Two-dimensional shear wave elastography for assessment ofliver stiff in rats with acute liver failure

Objective To explore the application value of two-dimensional shear wave elastography (2D-SWE) in detection of acute liver failure (ALF) and evaluation on prophylactic drug use in rats. Methods Totally of 28 male SD rats were divided into four groups, i.e. control group (n=8), model group (n=8), lactulose group (n=6) and Medilac-s group (n=6). From the 1st to the 8th day of the experiment, rats in Medilac-s group were treated with intragastric administration of Medilac-s after dilution, in lactulose group were given lactulose, while in control group and model group were given the same amount of normal saline. On the 6th and 7th day of the experiment, rats in model group, lactulose group and Medilac-s group were intraperitoneally injected with thioacetamide, while in control group were injected with normal saline. On the 8th day of the experiment, 2D-SWE was used for liver stiffness measurement (LSM) in all 4 groups. ROC curve was constructed, and the most accurate LSM value was selected according to AUC used for inter-group comparison. On the 9th day of the experiment, the liver of rats were taken for pathological examination. Results The main pathological manifestations in model group were inflammation and necrosis, in Medilac-s group and lactulose group were inflammation and necrosis less than in model group, whereas normal liver tissue was found in control group. Among ROC curves constructed by LSM value of the model group, the diagnostic efficiency of LSM_mean was the best. Taken 8.44 kPa as the cut-off value, the AUC, sensitivity and specificity was 0.768, 100% and 62.50%, respectively. LSM_mean in model group was significantly higher than that in the other 3 groups (all P<0.05). Conclusion Liver stiffness increases in ALF rats. 2D-SWE has application value for diagnosis of ALF and evaluation after prophylactic drug use.