目的:应用剪切波弹性成像(SWE)技术对非酒精性脂肪肝病(NAFLD)兔肝脏进行检测,并与病理结果对照,探讨SWE技术在NAFLD诊断及肝纤维化(LF)分级过程中的应用价值.方法:新西兰兔45只,按随机分为2组,一组10只,给予普通饲喂;一组35只,给予高脂饲喂.分别在16周及24周时应用SWE检测2组兔肝组织硬度值(LSM),24周检测结束后取出肝脏做病理检测,将符合NAFLD诊断的动物纳入研究作为实验组.结果:高脂组存活28只,全部纳入实验组,正常对照组10只,16周及24周实验组LSM均高于对照组,差异具有统计学意义(P均＜0.05),高脂喂养组中24周高于16周时的LSM,差异具有统计学意义(P＜0.05);对照组中24周的LSM高于16周,但差异不具有统计学意义(P＞0.05);病理组织学检测,S0期15只,S1期7只,S2期11只,S3期3只,S4期2只,各病理分期的LSM差异具有统计学意义(F=390.381,P=0.000).LSM与LF病理分期具有显著相关性(r=0.934,P=0.000).SWE技术诊断LF＞S0、S1、S2、S3的曲线下面积(AUC)分别为0.918、0.933、0.966、0.974.结论:SWE可定量测量NAFLD肝脏硬度及准确评估LF级别.%Objective:To explore the application value of shear wave elastography(SWE) in diagnosis of nonalcoholic fatty liver disease(NAFLD),by detection and analysis the liver stiffness measurement(LSM) of rabbits with NAFLD by SWE,in order to provide a practical and noninvasive clinical diagnosis technology of NAFLD.Methods:The 45 New Zealand white rabbits were divided randomly into the experimental group (n=35,with high fat diet) and the control group (n=10,with normal diet).The total test time was 24 weeks.We tested the LSM of all the rabbits in time of 16th and 24th week then killed all the rabbits and observed the liver histopathology after the ultrasonic test at the time of 24th weekend.Independent samples T-test of the various indexs of the rabbits in the two groups was performed using SPSS statistical software,version 22 (SPSS Inc.,Chicago,IL,USA) with all the data displayed as means±standard deviation.Pearson's correlation coefficient was used for analysis the LSM with the liver fibrosis (LF),and the receiver operating characteristic curve (ROC) was constructed to analyze the detection efficiency of LSM in the diagnosis of LF.Results:All the 28 high fat diet rabbits survived were involved in the experiment group,and the 10 rabbits in normal control group were all survived.LSM in experimental group were higher than the control group in time of 16th and 24th week respectively (P all＜0.05).And the LSM in the experimental group in time of 24th week was higher than the LSM in time of 16th week(t=10.857,P＜0.05).The pathological in the experiment group results show that there were 5 rabbits at stage S0,7 rabbits at stage S1,11 rabbits at stage S2,3 rabbits at stage S3,2 rabbits at stage S4.The difference of LSM between different level of LF had statistical significance (F=390.381,P＜0.001),the degree of LF and LSM showed a linear correlation(r=0.940,P=0.000).The areas under the ROC curve(AUC) was 0.918 when LSM diagnosis LF＞S0,AUC was 0.933 when LF＞S1,AUC was 0.966 when LF＞S2,AUC was 0.974 when LF＞S3 (early cirrhosis).Conclusion:SWE has high accuracy in the diagnosis and grading of NAFLD in rabbits,and may have a good application value in the evaluation of patients with NAFLD.
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