临床超声医学杂志
臨床超聲醫學雜誌
림상초성의학잡지
JOURNAL OF ULTRASOUND IN CLINICAL M,EDICINE
2014年
2期
10-13
,共4页
包中涛%叶真%古立娟%徐秋晨%许荣%黄秀烟
包中濤%葉真%古立娟%徐鞦晨%許榮%黃秀煙
포중도%협진%고립연%서추신%허영%황수연
超声检查%造影剂%超声弹性成像%肝纤维化%肝动静脉渡越时间%剪切波速
超聲檢查%造影劑%超聲彈性成像%肝纖維化%肝動靜脈渡越時間%剪切波速
초성검사%조영제%초성탄성성상%간섬유화%간동정맥도월시간%전절파속
Ultrasonography%Contrast agent%Ultrasonic elastography%Hepatic fibrosis%Hepatic artery to vein transit time%Shear wave velocity
目的:探讨超声造影测量肝动静脉渡越时间(HAVTT)及声脉冲辐射力技术测量剪切波速(SWV)在评估慢性乙型肝炎患者肝纤维化程度中的应用价值。方法83例S0~S4期慢性乙型肝炎肝病患者,对其肝脏行超声造影及弹性超声检查。超声造影采用目测法测量并计算HAVTT1和HAVTT2;利用声脉冲辐射力技术测量SWV。结果运用ROC曲线得到≥S1期、≥S2期、≥S3期和S4期的SWV参考阈值分别为1.41 m/s、1.81 m/s、2.14 m/s、2.40 m/s,HAVTT1参考阈值分别为11.6 s、10.5 s、9.5 s、7.4 s,HAVTT2参考阈值分别为14.1 s、12.4 s、11.6 s、9.4 s。SWV、HAVTT1、HAVTT2对肝纤维化分期诊断正确率分别为89.2%、72.3%、77.1%,前者高于后两者(P<0.05)。结论超声造影测量HAVTT可反映肝脏微循环的变化,可用于对S2期和S3期肝纤维化的鉴别诊断。超声弹性成像测量SWV能够反映肝纤维化分期的弹性硬度差异,较超声造影使用更方便、更无创,可作为评判肝纤维化程度及治疗疗效的一种新方法。
目的:探討超聲造影測量肝動靜脈渡越時間(HAVTT)及聲脈遲輻射力技術測量剪切波速(SWV)在評估慢性乙型肝炎患者肝纖維化程度中的應用價值。方法83例S0~S4期慢性乙型肝炎肝病患者,對其肝髒行超聲造影及彈性超聲檢查。超聲造影採用目測法測量併計算HAVTT1和HAVTT2;利用聲脈遲輻射力技術測量SWV。結果運用ROC麯線得到≥S1期、≥S2期、≥S3期和S4期的SWV參攷閾值分彆為1.41 m/s、1.81 m/s、2.14 m/s、2.40 m/s,HAVTT1參攷閾值分彆為11.6 s、10.5 s、9.5 s、7.4 s,HAVTT2參攷閾值分彆為14.1 s、12.4 s、11.6 s、9.4 s。SWV、HAVTT1、HAVTT2對肝纖維化分期診斷正確率分彆為89.2%、72.3%、77.1%,前者高于後兩者(P<0.05)。結論超聲造影測量HAVTT可反映肝髒微循環的變化,可用于對S2期和S3期肝纖維化的鑒彆診斷。超聲彈性成像測量SWV能夠反映肝纖維化分期的彈性硬度差異,較超聲造影使用更方便、更無創,可作為評判肝纖維化程度及治療療效的一種新方法。
목적:탐토초성조영측량간동정맥도월시간(HAVTT)급성맥충복사력기술측량전절파속(SWV)재평고만성을형간염환자간섬유화정도중적응용개치。방법83례S0~S4기만성을형간염간병환자,대기간장행초성조영급탄성초성검사。초성조영채용목측법측량병계산HAVTT1화HAVTT2;이용성맥충복사력기술측량SWV。결과운용ROC곡선득도≥S1기、≥S2기、≥S3기화S4기적SWV삼고역치분별위1.41 m/s、1.81 m/s、2.14 m/s、2.40 m/s,HAVTT1삼고역치분별위11.6 s、10.5 s、9.5 s、7.4 s,HAVTT2삼고역치분별위14.1 s、12.4 s、11.6 s、9.4 s。SWV、HAVTT1、HAVTT2대간섬유화분기진단정학솔분별위89.2%、72.3%、77.1%,전자고우후량자(P<0.05)。결론초성조영측량HAVTT가반영간장미순배적변화,가용우대S2기화S3기간섬유화적감별진단。초성탄성성상측량SWV능구반영간섬유화분기적탄성경도차이,교초성조영사용경방편、경무창,가작위평판간섬유화정도급치료료효적일충신방법。
Objective To explore the application value of the hepatic artery to vein transit time (HAVTT) measured by contrast-enhanced ultrasonography and liver shear wave velocity(SWV) measured by acoustic radiation force impulse(ARFI) technology in hepatic fibrosis caused by chronic hepatitis B. Methods The measurement of liver HAVTT and SWV were performed on 83 patients with chronic hepatitis B in stage0~stage4. HAVTT was measured using contrast-enhanced ultrasonography. SWV was measured using ARFI technology. Results Values of 11.6 s,10.5 s,9.5 s,7.4 s;14.1 s,12.4 s,11.6 s,9.4 s and 1.41 m/s,1.81 m/s,2.14 m/s,2.40 m/s were acquired for diagnosis of ≥S1,≥S2,≥S3 and S4 of HAVTT1,HAVTT2 and SWV using ROC curve method. The accuracy of SWV,HAVTT1 and HAVTT2 values for diagnosing hepatic fibrosis stage was 89.2%,72.3% and 77.1%, respectively, in which the accuracy of SWV was higher than that of HAVTT1 and HAVTT2(P<0.05). Conclusion HAVTT can reflects changes in hepatic microcirculation and be used as identification for S2, S3 of hepatic fibrosis. SWV can reflects hardness difference among every S stage and is more effective, convenient and non-invasive compared with contrast-enhanced ultrasonography, which can be a new method to judge hepatic fibrosis degree and therapeutic effect.