超声弹性成像及灰阶超声在肝纤维化诊断中的对比研究

摘要

目的:比较超声弹性成像(ultrasound elastosonography UE)及灰阶超声在肝纤维化诊断中的应用价值.方法:对120例慢性乙型肝炎患者的肝脏在进行超声引导下穿刺活检前进行超声弹性成像和灰阶超声检查,以病理结果为诊断金标准,分析超声弹性成像和灰阶超声评价肝纤维化的准确度.结果:超声弹性成像诊断肝纤维化的敏感度、特异度、准确度分别为92.5%、85.0%、90.0%.灰阶超声诊断肝纤维化的敏感度、特异度、准确度分别为42.5%,97.5%、60.8%.超声弹性成像联合灰阶超声诊断肝纤维化的敏感度、特异度、准确度分别为:93.7%,95.0%、94.2%.UE诊断准确度高于灰阶超声x2=32.59(P＜0.05).UE诊断肝纤维化的受试者特征(ROC)曲线下面积为0.874(95% CI,0.798～0.950).结论:超声弹性成像在评价肝纤维化较灰阶超声更有价值.%Objective,To compare the value of ultrasound elastosonography (UE) and grey-scale ultrasonography in the diagnosis of liver fibrosis. Methods : One hundred and twenty patients with chronic hepatitis B were prospectively examined by ultrasound elastosonography and grey-seale ultrasonography. Pathologic outcome was used as the golden diagnostic criterion. The accuracy of UE and grey-scale for diagnosing liver fibrosis were compared. Resulls : Sencitivity, specificity, accuracy of UE were 92. 5 ％ , 85. 0％ and 90. O ％ , respectively. Those of grey-scale ultrasonography were 42. 5％ , 97. 5％and 60. 8 ％ , respectively. And those of UE combined with grey-scale ulrasonography were 93. 7 ％ , 95. 0％ and 94. 2 ％,respectively. The accuracy of UE was higher than grey-scale ultrasonography in diagnosing liver fibrosis ( X2 = 32. 59 , P ＜0. 05). Area under ROC ultrasound elastosonography was 0. 874 (95％ Cl. 0. 798～0. 950 ). Concluslon : UE has better diagnostic value than grey-scale uitrasonography in the diagnosis of liver fibrosis.