肝脏剪切波速评价肝纤维化程度

摘要

目的 探讨肝脏剪切波速(SWV)评价肝纤维化程度的临床价值.方法 运用声触诊组织量化技术测量115例不同程度肝纤维化患者的肝脏SWV,分析SWV与患者各项临床指标之间的相关性,绘制ROC曲线评价SWV对肝纤维化的诊断效能.结果 肝脏SWV与患者年龄、球蛋白、总胆红素、纤维化分级、脂肪变性分级存在相关性(P均＜0.05),其中与纤维化分级的相关关系最密切(β＝0.431).以1.32、1.53、1.79、2.03 m/s作为诊断纤维化分级≥1、≥2、≥3、＝4的阈值,其曲线下面积分别为0.802、0.858、0.824、0.908.结论 肝脏SWV测值可直接反映肝脏质地,与纤维化病理分级显著相关,可无创评价肝纤维化程度.%Objective To investigate clinical application value of liver shear wave velocity (SWV) in assessment of liver fibrosis. Methods Virtual touch tissue quantification (VTQ) technique was used to obtain SWV values in 115 patients with different degrees of liver fibrosis. The correlation between SWV and each clinical parameters was analyzed, and the diagnostic efficacy was evaluated by ROC curve. Results Positive correlations were found between SWV and some parameters including age, globulin, total bilirubin, fibrosis grade and steatosis grade (all P<0. 05), and the maximum correlation coefficient was found between SWV and the fibrosis grade (β=0. 431). Using the cutoff value of 1. 32, 1. 53, 1. 79 and 2. 03 m/s for diagnosis of fibrosis grade ≥1, ≥2, ≥3 and =4, the corresponding area under ROC was 0. 802, 0. 858, 0. 824 and 0. 908, respectively. Conclusion SWV can directly reflect the elasticity modulus of liver, positively correlate with fibrosis grade, therefore non-invasively evaluate liver fibrosis.