CAJ | 학술논문

目的：初步探讨声学结构定量技术（ASQ）在无创性评价肝纤维化程度中的应用价值。方法运用装有ASQ软件的超声仪器对100例正常对照组及120例病理明确的慢性乙型肝炎患者进行肝脏扫查，分析肝实质回声的原始回波信号，记录比较并分析其卡方直方图和参数：Mode（众数）、Average（均数）、SD（标准差）、B/R（蓝红曲线下面积之比）。将以上参数与病理肝纤维化程度进行相关性分析，对相关性较好的参数指标分别以肝纤维化程度S≥1及S≥3为不同研究终点分组进行受试者工作特征曲线（ROC）分析并确定最佳界值。结果随着肝纤维化程度的增加，红色曲线及蓝色曲线的走行由平滑、锐利变得粗糙、曲折，蓝色曲线下面积逐渐增大。红色曲线Mode值、Average值在各组之间比较有显著性差异（P＜0.01），SD值在除中度（S3）与重度（S4）肝纤维化组以外各组之间均有显著性差异（P＜0.01）。蓝色曲线Mode值与Average值在各组之间有显著性差异（P＜0.01）。B/R值在各组之间均有显著性差异（P＜0.01）且与肝纤维化程度有较好正相关（r＝0.77，P＜0.05），对B/R进行ROC分析，S≥1时受试者特征曲线下面积（AUROC）为0.88，S≥3时AUROC 为0.96。结论声学结构定量技术是一项非侵入性评价肝纤维化程度的新技术，在肝纤维化分期尤其是早期肝硬化的诊断中有广阔的应用前景。
목적：초보탐토성학결구정량기술（ASQ）재무창성평개간섬유화정도중적응용개치。방법운용장유ASQ연건적초성의기대100례정상대조조급120례병리명학적만성을형간염환자진행간장소사，분석간실질회성적원시회파신호，기록비교병분석기잡방직방도화삼수：Mode（음수）、Average（균수）、SD（표준차）、B/R（람홍곡선하면적지비）。장이상삼수여병리간섬유화정도진행상관성분석，대상관성교호적삼수지표분별이간섬유화정도S≥1급S≥3위불동연구종점분조진행수시자공작특정곡선（ROC）분석병학정최가계치。결과수착간섬유화정도적증가，홍색곡선급람색곡선적주행유평활、예리변득조조、곡절，람색곡선하면적축점증대。홍색곡선Mode치、Average치재각조지간비교유현저성차이（P＜0.01），SD치재제중도（S3）여중도（S4）간섬유화조이외각조지간균유현저성차이（P＜0.01）。람색곡선Mode치여Average치재각조지간유현저성차이（P＜0.01）。B/R치재각조지간균유현저성차이（P＜0.01）차여간섬유화정도유교호정상관（r＝0.77，P＜0.05），대B/R진행ROC분석，S≥1시수시자특정곡선하면적（AUROC）위0.88，S≥3시AUROC 위0.96。결론성학결구정량기술시일항비침입성평개간섬유화정도적신기술，재간섬유화분기우기시조기간경화적진단중유엄활적응용전경。
Objective To explore the diagnostic value of acoustic structure of quantitative techniques (ASQ) in the assessment of liver fibrosis. Methods 100 normal subjects and 120 patients with histologically proven chronic hepatitis B virus were examined by B-Mode ultrasound with ASQ software. The raw echo signal of images was analyzed and parameters such as mean, average, standard deviation, the ratio of blue and red color histogram curve area were observed to evaluate the correlation between ASQ values and the pathologic result of liver fibrosis. For well-correlation parameter, ROC was analyzed to get the optimal cutoff value for liver fibrosis S≥1 and S≥3. Results With the degree of liver fibrosis increased, red histogram curve and blue histogram curve in the horizontal distribution was rough, right moved, the area under blue curve was much larger than the red. RedMode, RedAverage, BlueMode and BlueAverage showed a statistical difference between each two groups(P<0.01). RedSD showed a statistical difference between each two groups(P<0.01) except that between s3 subgroup and s4 subgroup(P>0.05). The relative gap of standardized ratio of blue and red color histogram curve area in each group were much larger than the other six indicators. The areas under ROC curves were 0.88 for S≥1 and 0.96 for S≥3. Conclusion The ASQ technology is a novel, noninvasive and promising tool for the assessment of liver fibrosis, especially in early cirrhosis.