剪切波弹性成像评估大鼠非酒精性脂肪肝病肝纤维化程度

目的探讨剪切波弹性成像(SWE)技术评估大鼠非酒精性脂肪肝病(NAFLD)肝纤维化程度的应用价值。方法将88只SD大鼠随机分为对照组(40只)和实验组(48只),对照组给予普通饲喂,实验组通过饮食调配建立不同肝纤维化分期的NAFLD模型,分别于第1、2、3、8、12周末随机抽取对照组大鼠8只,与预定喂养结束的实验组大鼠一起行SWE检查获取肝脏杨氏模量平均值(Emean),并处死行病理检查;绘制受试者工作特征(ROC)曲线分析Emean预测不同肝纤维化程度的诊断效能。结果肝纤维化F0期、F1期、F2期、F3期、F4期分别有52只、6只、6只、18只、6只,考虑建模成功,其对应的Emean分别为(5.46±0.37)kPa、(6.28±0.33)kPa、(6.42±0.41)kPa、(9.01±0.95)kPa及(15.88±2.49)kPa,不同肝纤维化分期Emean比较差异有统计学意义(F=25.5,P<0.05);除F1期与F2期比较差异无统计学意义外,其余任意两两比较差异均有统计学意义(均P<0.05)。所有大鼠肝脏Emean与肝纤维化程度呈显著正相关(r=0.82,P<0.001)。SWE诊断肝纤维化≥F1、≥F2、≥F3、F4期的截断值分别为6.3 kPa、7.4 kPa、8.6 kPa、9.7 kPa,曲线下面积分别为0.87、0.89、0.93、0.98,敏感性和特异性分别为83.3%、93.3%、100%、100%和85.5%、83.1%、91.3%、92.7%。结论SWE技术可有效评估大鼠NAFLD肝纤维化程度。

Research on liver fibrosis for rat models of nonalcoholic fatty liver disease by shear wave elastography

Objective To explore the application value of shear wave elastography(SWE)used to evaluate hepaticfibrosis for rat models of nonalcoholic fatty liver disease(NAFLD).MethodsEighty-eight SD rats were randomly divided intocontrol group(n=40)and experimental group(n=48).Normal diet was fed to rats of the control group.Different diets were fed torats of experimental group to produce various stages of hepatic fibrosis model.Eight rats were imaged by SWE in the time of 1 st,2 nd,3 rd,8 th,12 th week,respectively.Livers were subjected to histopathologic evaluation every time after SWE.The diagnosticeffiacy of Emean in predicting different degree liver fibrosis by ROC curre.ResultsNumber of rats in liver fibrosis stage F0,F1,F2,F3 and F4 were 52,6,6,18,and 6,their Emean were(5.46±0.37)k Pa,(6.28±0.33)k Pa,(6.42±0.41)k Pa,(9.01±0.95)k Paand(15.88±2.49)k Pa,respectively,there were significant differences between different stages of liver fibrosis(F=25.5,P<0.05).And except for the difference between F1 and F2,there were statistically significant difference among other stages(all P<0.05).Emean of rats was significantly positively correlated with the degree of liver fibrosis(r=0.82,P<0.001).According to the ROCcurve,the cutoff value for SWE in diagnosis of liver fibrosis≥F1,≥F2,≥F3,and F4 were 6.3 k Pa,7.4 k Pa,8.6 k Pa,and 9.7 k Pa,respectively,and the areas under the curve were 0.87,0.89,0.93 and 0.98,respectively.The sensitivity and specificity were 83.3%,93.3%,100%,100%and 85.5%,83.1%,91.3%,92.7%,respectively.ConclusionSWE is potentially helpful for staging thedegree of hepatic fibrosis in rat models of NAFLD.