CAJ | 학술논문

目的探讨声触诊组织量化(virtual touch tissue quantification,VTQ)技术无创评估乙肝肝硬化食管静脉曲张(esophageal varices,EV)程度的可行性.方法应用VTQ技术对135例乙型肝炎后肝硬化患者分别测量肝、脾剪切波速度值(shear wave velocity,SWV)；同时行胃镜检查,分为无食管静脉曲张组与食管静脉曲张组(按食管静脉曲张程度分为轻、中、重三级)；检查肝生化指标;将所得的肝SWV及脾SWV值进行对比分析.结果乙肝肝硬化患者的肝SWV均值为(2.48±0.50) m/s；肝SWV值与食管静脉曲张分级间无相关性(P=0.167).乙肝肝硬化患者的脾SWV均值为(3.25±0.44)m/s;脾SWV值与食管静脉曲张分级高度相关,相关系数为0.66(P＜0.001);诊断存在食管静脉曲张的临界值为3.16m/s,灵敏度、特异度分别为0.83,0.80,ROC曲线下面积为0.83;诊断重度食管静脉曲张的临界值为3.39m/s,灵敏度、特异度分别为0.83,0.77,ROC曲线下面积为0.84.结论 VTQ技术测定的脾SWV值可无创评估乙肝肝硬化患者食管静脉曲张程度,但未发现肝SWV值可用于评估食管静脉曲张程度.
목적 탐토성촉진조직양화(virtual touch tissue quantification,VTQ)기술무창평고을간간경화식관정맥곡장(esophageal varices,EV)정도적가행성.방법 응용VTQ기술대135례을형간염후간경화환자분별측량간、비전절파속도치(shear wave velocity,SWV)；동시행위경검사,분위무식관정맥곡장조여식관정맥곡장조(안식관정맥곡장정도분위경、중、중삼급)；검사간생화지표;장소득적간SWV급비SWV치진행대비분석.결과 을간간경화환자적간SWV균치위(2.48±0.50) m/s；간SWV치여식관정맥곡장분급간무상관성(P=0.167).을간간경화환자적비SWV균치위(3.25±0.44)m/s;비SWV치여식관정맥곡장분급고도상관,상관계수위0.66(P＜0.001);진단존재식관정맥곡장적림계치위3.16m/s,령민도、특이도분별위0.83,0.80,ROC곡선하면적위0.83;진단중도식관정맥곡장적림계치위3.39m/s,령민도、특이도분별위0.83,0.77,ROC곡선하면적위0.84.결론 VTQ기술측정적비SWV치가무창평고을간간경화환자식관정맥곡장정도,단미발현간SWV치가용우평고식관정맥곡장정도.
Objective To evaluate the performance of virtual touch tissue quantification (VTQ)technique in noninvasive assessment of esophageal varices (EV) in patients with hepatitis B cirrhosis.Methods One hundred and thirty-five patients were enrolled in this study.Liver shear wave velocity (LSWV) and spleen shear wave velocity (SSWV) were obtained by VTQ technique,and the detection of EV was performed by upper endoscopy per patient.The severity of EV was staged on a G1-G3 scale.Liver function was also tested.Results The mean value of LSWV in patients with cirrhosis was (2.48±0.50)m/s,LSWV was not correlated with the stage of EV.The mean value of SSWV was (3.25 ± 0.44) m/s,a significant,direct,linear correlation ( r =0.66,P＜0.001 ) was found between SSWV and the stage of EV.The cut-off value of SSWV for predicting the presence of EV was 3.16 m/s and the area under ROC curve was 0.83,with the sensitivity and specificity of 0.83 and 0.80,respectively.The cut-off value of SSWV for predicting severe EV was 3.39m/s and the area under ROC curve was 0.84,with the sensitivity and specificity of 0.83 and 0.77,respectively.Conclusions In cirrhotic patients infected with hepatitis B virus,SSWV measured by VTQ technique can be used as a noninvasive method for determining the presence and the severity of EV,however evidence to support a similar role for LSWV is lacking.