超声造影评价肝纤维化程度的临床应用价值

摘要

To study the clinical application value of evaluating chronic hepatitis B liver fibrosis withcontrast enhanced ultrasound and to filter the close parameters. Methods The study included 38 patients with chronic hepatitis B and 8 healthy controls. Under the mode of pulse-inversion harmonic imaging, bolus of ultrasound contrast agent was injected through cubital vein, then hepatic artery arrival time( HAAT ), portal vein arrival time ( PVAT ), hepatic vein arrival time( HVAT )were recorded. The interval time between HAAT and HVAT( VAT ) and the interval time between portal VAT and hepatic vein arrival time ( VVT ) were calculated. Results The HAAT and PVAT showed no correlation with the stage of chronic hepatitis B' liver fibrosis. The HVAT, VAT, VVT decreased with increase of liver fibrosis( P <0. 05 ). HVAT, VAT, VVT correlated negatively with the development of fibrosis( P < 0. 01 ). The correlation coefficient of VVT was highest( r = - 0. 88 ). Conclusion HVAT, VAT, VVT are closely associated with the stage of liver fibrosis, especially VAT, VVT can evaluate the stage of liver fibrosis indirectly.%目的 研究超声造影评价慢性乙型肝炎肝纤维化的临床应用价值,筛选与肝纤维化程度密切相关的评估参数.方法 选择慢性乙型肝炎患者38例及健康对照组8例在反相脉冲谐波模式下,经肘静脉团注超声造影剂声诺维(SonoVue),测定造影剂到达肝动脉时间(HAAT),到达门静脉时间(PVAT),到达肝静脉时间(HVAT),计算造影剂达到肝动-静脉时间之差即肝动-静脉渡越时间(VAT),肝-门静脉到达时间之差即肝-门静脉渡越时间(VVT).结果 不同程度肝纤维化患者的HAAT、PVAT比较差异无统计学意义.HVAT、VAT、VVT随着肝纤维化程度的加重而缩短(P<0.05),HVAT、VAT、VVT与肝纤维化程度均呈负相关(P<0.01),且VVT相关性最高(r=-0.88).结论 HVAT、VAT、VVT与肝纤维化程度密切相关,尤其是VAT、VVT可作为间接评价肝纤维化程度的指标.