Objective To investigate the relationship between real-time shear wave elasticity imaging (SWE) Young's modulus and serology in evaluation the degree of liver fibrosis patients with non-alcoholic fatty liver disease (NAFLD).Methods One hundred and thirty-four cases underwent liver biopsy in patients with NAFLD in the First Affiliated Hospital of Zhengzhou University were analyzed retrospectively, the measured liver of Young's modulus and Apri index,aspartate transaminase (AST),alanine transarninase (ALT),liver wear fibrosis stage were compared and analyzed;the Young's modulus measurement accuracy in the assessment of liver fibrosis of different subjects for the area under the curve was statistically analyzed.Results (1) In NAFLD liver fibrosis stage S0,S1, S2, S3, S4, Young's modulus [kPa,M(P25,P75)] were 7.5(6.4,8.1),9.7(7.2,10.4),10.3(9.8,14.6),16(10.2,23.5),19.7 (15.4,23.9) respectively. (2) With the degree of liver fibrosis increased,Young's modulus of NAFLD patients was positively correlated with APRI, AST, ALT, AST/ALT ratio. There was a significant positive correlation between Young's modulus and the degree of liver fibrosis (r=0.564, P<0.01). (3) According to Young's modulus meas-ured value to determine the staging of liver fibrosis and draw the ROC curve,S1,S2,S3,S4 curve area were 0.560, 0.785,0.867,0.959,the threshold of distinguishing S0 and S1 was 7.8 kPa and corresponding sensitivity and speci-ficity were 67.3% and 53.6%,the threshold of distinguishing S1 and S2 was 9.65 kPa, the corresponding sensitivity and specificity were 83.3% and 69.6%, the threshold of distinguishing S2 and S3 was 9.85 kPa, the corresponding sensitivity and specificity were 100% and 68.3%,the threshold of distinguishing S3 and S4 was 13.8 kPa,correspond-ing sensitivity and specificity were 100% and 100%.Conclusion SWE Young's modulus in the evaluation of liver fi-brosis and hepatic pathology in NAFLD has good effect,it can be as a noninvasive diagnostic method for NAFLD.%目的 探讨实时剪切波弹性成像(SWE)检查肝脏杨氏模量与血清学检查评价非酒精性脂肪性肝病(non-alcoholic fatty liver disease,NAFLD)患者的肝纤维化程度相关性.方法 回顾性分析134例在郑州大学第一附属医院行肝脏穿刺活检的NAFLD患者,将测得肝脏杨氏模量与APRI指数、天冬氨酸转氨酶(AST)、丙氨酸转氨酶(ALT)、肝穿病理纤维化分期进行对比分析;并根据不同受试者工作曲线下面积进行统计学分析,判断杨氏模量测值评价肝纤维化程度的准确性.结果 (1)NAFLD肝纤维化分期S0、S1、S2、S3、S4期杨氏模量测值[kPa,M(P25,P75)]分别为7.5(6.4,8.1)、9.7(7.2,10.4)、10.3(9.8,14.6)、16(10.2,23.5)、19.7(15.4,23.9).(2)随着肝纤维化程度加重,NAFLD患者杨氏模量与APRI、AST、ALT、AST/ALT比值均呈正相关.其中杨氏模量测值与肝纤维化程度存在显著正相关(r=0.564,P<0.01).(3)根据杨氏模量测值判断肝纤维化分期绘制ROC曲线,S1、S2、S3、S4曲线下面积分别为0.560、0.785、0.867、0.959;区分S0与S1的阈值为7.8 kPa,对应敏感度、特异度为67.3%和53.6%,区分S1与S2的阈值为9.65 kPa,对应敏感度、特异度为83.3%和69.6%,区分S2与S3的阈值为9.85 kPa,对应敏感度、特异度为100%和68.3%,区分S3与S4的阈值为13.8 kPa,对应敏感度、特异度为100%和100%.结论 SWE检查肝脏杨氏模量评价NAFLD肝纤维化与肝脏病理有较好的效果,可作为评估NAFLD的一种无创诊断方法.
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