声触诊组织量化技术对肝纤维化的诊断价值

目的 评估声触诊组织量化（VTQ）技术对肝纤维化的诊断价值.方法 选取2011年6月~2012年12月来我院就诊的慢性肝炎患者（慢性肝炎组）60例、肝硬化患者（肝硬化组）45例及健康体检者（健康对照组）25例,利用VTQ技术测定右肝感兴趣区肝脏横向剪切波速度（SWV）;慢性肝炎患者同期行肝穿刺活检病理检查,分析SWV与肝纤维化程度的相关性,采用受试者工作特征（ROC）曲线,评价VTQ技术诊断肝纤维化的准确性.结果 健康对照组、慢性肝炎组及肝硬化组肝脏SWV分别为（2.0±0.2）m/s、（2.3±0.4）m/s 和（3.1±0.5）m/s,3者间具有显著性差异（P＜0.05）.随着肝纤维化程度加深,肝脏SWV增高,SWV值与肝纤维化分期呈正相关,相关系数为0.73（P〈0.05）;诊断≥S2及≥S3的ROC曲线下面积为0.94、0.92,诊断的临界值为1.36m/s、1.69m/s,灵敏性、特异性分别为0.88、0.88,0.92、0.76.结论 VTQ技术对肝纤维化具有较高的诊断价值.

Diagnostic value of virtual touch tissues quantification for liver fibrosis

Objective To investigate the diagnostic value of virtual touch tissues quantification （VTQ） in the assess- ment of liver fibrosis. Methods From Jun 2011 to Dec 2012, VTQ was performed in 60 cases with chronic hepatitis, 45 cases with liver cirrhosis and 25 healthy persons, and the shear wave velocity （SWV） was measured in regions of interest of the right hepatic lobe. The patients with chronic hepatitis underwent liver biopsy. The relationship between SWV and liver fibrosis grade was analyzed, and the accuracy of VTQ in diagnosising liver fibrosis was evaluated by receiver operating haraeteristie curve （ROC curve）. Results The values of SWV in healthy persons, patients with chronic hepatitis and liver cirrhosis were （2.0±0.2）m/s , （2.3 ±0.4）m/s and （3.1±0.5 ）m/s, respectively. There were significant difference among the three groups （P〈0.05）. The SWV values increased as the severity of liver fibrosis progressed, and were associated with liver fibrosis grade （r=0.73 ,P〈 0.05）. The areas under the ROC curves were 0.94 for S2 and 0.92 for S3; the cut-off values were 1.36 m/s for S2 （sensitivi- ty 0.88%, specificity 0.88%） and 1.69 m/s for S3 （sensitivity 0.92, specificity 0.76 ）. Conclusion The VTQ technique has important value on diagnosing liver fibrosis.