超声微泡肝内渡越时间无创性评价肝纤维化程度的可行性

摘要

目的 探讨超声造影(CEUS)微泡肝内渡越时间评价肝纤维化程度的可行性.方法 根据Scheuer评分将83例慢性乙肝患者分为无纤维化组(S0期)、轻度肝纤维化组(S1～S2期)、中度肝纤维化组(S3期)和重度肝纤维化组(S4期),分别行CEUS检查,计算对比剂肝动脉-肝静脉渡越时间(HA-HVTT)、门静脉-肝静脉渡越时间(PV-HVTT)及肝实质-肝静脉渡越时间(PA-HVTT),比较各组渡越时间与肝纤维化程度的相关性.结果 无纤维化组HA-HVTT、PV-HVTT、PA-HVTT与对照组无显著差异(P＞0.05),轻度肝纤维化组、中度肝纤维化组、重度肝纤维化组HA-HVTT、PV-H VTT、PA-HVTT与对照组均有显著差异(P＜0.05).PV-H VTT在无纤维化组、轻度肝纤维化组、中度肝纤维化组、重度肝纤维化组两两比较均有差异(P＜0.05),HA-HVTT、PA-HVTT在无纤维化组与轻度肝纤维化组之间、轻度肝纤维化组与重度肝纤维化组之间有差异(P＜0.05).HA-HVTT、PV-HVTT和PA-HVTT与纤维化程度均呈负相关(r =-0.53,r=-0.71,r=-0.48,P＜0.01).结论 CEUS获取的肝内渡越时间是无创性评价肝纤维化程度的参考依据.%Objective To investigate the feasibility of intrahepatic transit time got by contrast-enhanced ultrasonography (CEUS) in the evaluation of liver fibrosis. Methods According to the scheuer scoring system for staging liver fibrosis, 83 patients infected with hepatic B virus were divided into no fibrosis group (SO) , mild fibrosis group (S1~S2), moderate fibrosis group (S3) and severe fibrosis group (S4). All patients were examined with CEUS. Intrahepatic transit time was calculated as the difference in arrival time between hepatic artery (HA) and HV (HA-HVTT), between PV and HV(PV-HVTT) , and between PA and HV(PA-HVTT). The orrelation between intrahepatic transit time and the severity of liver fibrosis was analysed. Results Except for the no fibrosis group, there were significant differences between another group and control group ( P <0. 05~0. 01) of the intrahepatic transit time (HA-HVTT, PV-HVTT, PA-HVTT). There were significant differences between every two group in the result of PV-HVTT ( P <0. 05), while in HA-HVTT and PA-HVTT, only between no fibrosis and mild fibrosis group, mild fibrosis and severe fibrosis group there were significant differences ( P<0. 05). Intrahepatic transit time (HA-HVTT,PV-HVTT and PA-HVTT) correlated negatively with the degree of fibrosis( r =-0. 53, r =-0. 71, r = -0. 48, P <0. 01). Conclusion Intrahepatic transit time got by CEUS is an important parameter in in evaluating liver fibrosis non-invasively.