声触诊组织量化技术与灰阶超声对肝硬化的诊断效能对比
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摘要
目的:比较声触诊组织量化(virtual touch tissues quantification,VTQ)技术与灰阶超声对肝硬化的诊断效能。方法:102例肝穿刺活检或肝手术前后1周的患者接受灰阶超声检查,对肝包膜、肝实质回声、脾脏大小进行评分;同时采用ACUSON S2000超声仪对患者进行VTQ测量。以病理结果作为金标准,分别绘制受试者工作特征曲线(receiver operating characteristic curve,ROC),比较两种方法对肝硬化的诊断效能。结果:病理学检查结果显示,102例患者中S0期7例、S1期9例、S2期13例、S3期21例、S4期52例。VTQ及灰阶超声诊断肝硬化曲线下面积分别为0.876、0.830,差异有统计学意义(P=0.000)。结论:VTQ诊断肝硬化的效能优于灰阶超声,对临床治疗的指导价值可能更大。
Objective:To compare the diagnostic efficacy of virtual touch tissues quantification(VTQ)and gray-scale ultrasound in liver cirrhosis.Methods:Gray-scale ultrasound was performed in 102 patients who underwent liver biopsy or liver operation.And the Glisson capsule,echo of hepatic parenchyma and spleen size were scored.The liver stiffness measurements were also performed by ACUSON S2000.The receiver operating characteristic curve(ROC)was constructed respectively to compare the diagnostic efficacy of the two methods for liver cirrhosis taking pathological findings as gold standard.Results:Pathological findings showed that there were 7 cases of stage S0,9 cases of stage S1,13 cases of stage S2,21 cases of stage S3 and 52 cases of stage S4.The area under ROC of VTQ and gray-scale ultrasound in diagnosing liver cirrhosis was respectively0.876 and 0.830,with significant difference(P=0.000).Conclusions:VTQ is superior to gray-scale ultrasound in diagnosing liver cirrhosis and can offer valuable information for clinical treatment.
Objective:To compare the diagnostic efficacy of virtual touch tissues quantification(VTQ)and gray-scale ultrasound in liver cirrhosis.Methods:Gray-scale ultrasound was performed in 102 patients who underwent liver biopsy or liver operation.And the Glisson capsule,echo of hepatic parenchyma and spleen size were scored.The liver stiffness measurements were also performed by ACUSON S2000.The receiver operating characteristic curve(ROC)was constructed respectively to compare the diagnostic efficacy of the two methods for liver cirrhosis taking pathological findings as gold standard.Results:Pathological findings showed that there were 7 cases of stage S0,9 cases of stage S1,13 cases of stage S2,21 cases of stage S3 and 52 cases of stage S4.The area under ROC of VTQ and gray-scale ultrasound in diagnosing liver cirrhosis was respectively0.876 and 0.830,with significant difference(P=0.000).Conclusions:VTQ is superior to gray-scale ultrasound in diagnosing liver cirrhosis and can offer valuable information for clinical treatment.
引文
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[9]丁红,马娇娇,王文平,等.剪切波组织定量技术评估肝弹性硬度的多因素回归分析:初步临床研究[J].中华超声影像学杂志,2013,22(12):1041-1044.
[10]JAIN V,DIXIT R,CHOWDHURY V,et al.Can acoustic radiation force impulse elastography be a substitute for liver biopsy in predicting liver fibrosis?[J].Clin Radiol,2016,71(9):869-875.
[2]REGEV A,BERHO M,JEFFERS L J,et al.Sampling error and intraobserver variation in liver biopsy in patients with chronic HCV infection[J].Am J Gastroenterol,2002,97(10):2614-2618.
[3]CADRANELJ F,RUFAT P,DEGOS F.Practices of liver biopsy in France:results of a prospective nationwide survey.For the Group of Epidemiology of the French Association for the Study of the Liver(AFEF)[J].Hepatology,2000,32(3):477-481.
[4]SHERMAN D,LUNG P,SHORVON P.Virtual touch quantification(VTq)elastography for non-invasive assessment of liver disease and its complications:what the clinician needs to know[J].Frontline Gastroenterol,2017,8(1):37-44.
[5]沈文,丁红,马姣姣,等.声触诊组织量化技术测量肝硬度的可重复性研究[J].中国临床医学,2013,20(6):838-839,842.
[6]SHUANG-MING T,PING Z,YING Q,et al.Usefulness of acoustic radiation force impulse imaging in the differential diagnosis of benign and malignant liver lesions[J].Acad Radiol,2011,18(7):810-815.
[7]GERSAK M M,SORANTIN E,WINDHABER J,et al.The influence of acute physical effort on liver stiffness estimation using Virtual Touch Quantification(VTQ).Preliminary results[J].Med Ultrason,2016,18(2):151-156.
[8]HARRIS N,NADEBAUM D,CHRISTIE M,et al.Acoustic radiation force impulse accuracy and the impact of hepatic steatosis on liver fibrosis staging[J].J Med Imaging Radiat Oncol,2016,60(5):587-592.
[9]丁红,马娇娇,王文平,等.剪切波组织定量技术评估肝弹性硬度的多因素回归分析:初步临床研究[J].中华超声影像学杂志,2013,22(12):1041-1044.
[10]JAIN V,DIXIT R,CHOWDHURY V,et al.Can acoustic radiation force impulse elastography be a substitute for liver biopsy in predicting liver fibrosis?[J].Clin Radiol,2016,71(9):869-875.