CAJ | 학술논문

目的对比分析实时剪切波弹性成像(real-time shear wave elastography,SWE)和常规超声检查评估慢性乙型肝炎肝纤维化的价值.方法对114例行肝组织学活检的慢性乙型肝炎患者同时行常规超声和SWE检查.常规超声对肝包膜、肝实质和脾大小进行半定量评分,评分相加为超声积分;SWE检测肝弹性模量.以肝组织病理学结果为金标准,比较SWE、常规超声与肝纤维化病理分期的相关系数、诊断肝纤维化各分期的ROC曲线下面积,以及不同操作者之间的组内相关系数(ICC).结果 SWE与肝纤维化病理分期的相关系数(r=0.799,95％ CI0.413-0.670,P=0.000)高于常规超声(r1=0.530,95％CI0.721-0.857,P=0.000).常规超声和SWE诊断肝纤维化病理分期S≥2、S≥3和S=4的ROC曲线下面积分别为0.765和0.892、0.763和0.941、0.800和0.965,SWE高于常规超声(P=0.008、P＜0.001、P=0.005).SWE的ICC(0.968,95％CI0.928-0.986)高于常规超声(0.886,95％CI0.834-0.921).结论 SWE简便易行,可重复性好,诊断肝纤维化准确性高,能弥补常规超声的不足.
목적 대비분석실시전절파탄성성상(real-time shear wave elastography,SWE)화상규초성검사평고만성을형간염간섬유화적개치.방법 대114례행간조직학활검적만성을형간염환자동시행상규초성화SWE검사.상규초성대간포막、간실질화비대소진행반정량평분,평분상가위초성적분;SWE검측간탄성모량.이간조직병이학결과위금표준,비교SWE、상규초성여간섬유화병리분기적상관계수、진단간섬유화각분기적ROC곡선하면적,이급불동조작자지간적조내상관계수(ICC).결과 SWE여간섬유화병리분기적상관계수(r=0.799,95％ CI0.413-0.670,P=0.000)고우상규초성(r1=0.530,95％CI0.721-0.857,P=0.000).상규초성화SWE진단간섬유화병리분기S≥2、S≥3화S=4적ROC곡선하면적분별위0.765화0.892、0.763화0.941、0.800화0.965,SWE고우상규초성(P=0.008、P＜0.001、P=0.005).SWE적ICC(0.968,95％CI0.928-0.986)고우상규초성(0.886,95％CI0.834-0.921).결론 SWE간편역행,가중복성호,진단간섬유화준학성고,능미보상규초성적불족.
Objective To compare real-time shear wave elastography (SWE) with conventional ultrasonography(US) in the assessment of liver fibrosis in patients with chronic hepatitis B.Methods One hundred and fourteen patients with chronic hepatitis B scheduled for liver biopsy were studied.Both SWE and US were performed on these patients in a single day.The SWE assessed the liver fibrosis with elasticity modulus,while US with a scoring system consisted of liver surface,parenchyma and splenic size.The correlation coefficient of liver fibrosis level,receiver operating characteristic (ROC) curve of S≥2,S≥3 and S =4 and the interclass correlation coefficient (ICC) of SWE and US were compared.Results The correlation coefficient of liver fibrosis level for SWE (r =0.799,95％CI 0.413-0.670,P =0.000) was higher than US scores (r =0.530,95％CI 0.721-0.857,P =0.000).The area under ROC curves for S≥ 2,S≥3 and S=4 of US and SWE were 0.765 and 0.892,0.763 and 0.941,0.800 and 0.965,respectively,which indicated that SWE was better than US scores for the evaluation of liver fibrosis(P =0.008,P ＜ 0.001,P =0.005),respectively.The ICC of SWE (ICC =0.968,95％CI 0.928-0.986) was higer than US scores (ICC =0.886,95 ％CI 0.834-0.921).Conclusions SWE has high reproducibility and accuracy in the assessment of liver fibrosis in chronic hepotitis B,and was better than US.