超声定量评估非酒精性脂肪性肝病患者肝脏ARFI值对显著NASH的诊断价值分析

doi:10.3969/j.issn.1672-5069.2019.03.017

摘要/Abstract

摘要： 目的探讨采用声辐射力脉冲成像技术（ARFI）定量评估非酒精性脂肪性肝病（NAFLD）患者肝脏炎症的应用价值。方法在经肝活检病理学检查诊断的非酒精性单纯性脂肪肝（NAFL）患者31例、明显非酒精性脂肪性肝炎（NASH）患者31例和显著NASH患者31例及健康人31例,使用超声检测左肝和右肝4 cm、6 cm和8 cm位点ARFI值变化。结果健康人、NAFL、明显NASH和显著NASH患者左肝4 cm、6 cm和8 cm位点ARFI平均值分别为（1.32±0.15） m/s 、（1.25±0.12） m/s 、（1.18±0.11） m/s 和（1.05±0.10） m/s,右肝ARFI平均值分别为（1.08±0.09） m/s、（0.94±0.08） m/s、（0.89±0.09） m/s 和（0.84±0.07） m/s,左右肝ARFI平均值分别为（1.19±0.10） m/s、（1.10±0.09） m/s、（1.02±0.08） m/s和（0.93±0.08） m/s,显示显著性NASH患者ARFI值显著降低（P<0.05）;四组左肝在8 cm位点ARFI值分别为（1.18±0.14）m/s、（1.02±0.13） m/s、（0.87±0.15） m/s 和（0.71±0.11） m/s,右肝在6 cm位点 ARFI值分别为（1.06±0.10） m/s、（0.95±0.09） m/s、（0.90±0.08） m/s和（0.85±0.07） m/s,右肝在8 cm位点ARFI值分别为（1.02±0.07） m/s、（0.91±0.06） m/s、（0.81±0.08） m/s和（0.72±0.05） m/s,显示显著NASH患者ARFI值显著降低（P<0.05）。结论 ARFI技术定量评估NAFLD患者肝脏损害程度有助于对显著NASH患者的诊断,可能具有一定的临床意义。

关键词: 非酒精性脂肪性肝病, 非酒精性脂肪性肝炎, 超声, 声辐射力脉冲成像技术, 诊断

Abstract: Objectiv The aim of this study was to explore the application of acoustic radiation force impulse （ARFI） quantification in the evaluation of liver injuries in patients with non-alcoholic fatty liver disease （NAFLD）. Methods Clinical data of 31 patients with nonalcoholic simple fatty liver（NAFL）,31 with obvious non-alcoholic steatohepatitis（NASH） and 31 with significant NASH,diagnosed by liver pathological examination, and 31 normal persons were retrospectively analyzed. The mean ARFI values at 4 cm,6 cm and 8 cm in left and right livers were detected by sonography. Results The mean ARFI values of 4 cm,6 cm and 8 cm sites in the left liver of patients with normal persons,NAFL,obvious NASH and significant NASH were（1.32±0.15） m/s,（1.25±0.12） m/s,（1.18±0.11） m/s and （1.05±0.10） m/s,in right liver of the three sites were（1.08±0.09） m/s,（0.94±0.08） m/s,（0.89±0.09） m/s and （0.84±0.07） m/s, and the whole liver ARFI of right and left were （1.19±0.10） m/s,（1.10±0.09） m/s,（1.02±0.08） m/s and（0.93±0.08）m/s,showing the significantly decreased ARFI value in patients with significant NASH （P<0.05）;the ARFI of the four groups at 8 cm in left liver were （1.18±0.14）m/s,（1.02±0.13）m/s,（0.87±0.15）m/s and（0.71±0.11） m/s,at 6 cm in right liver were （1.06±0.10） m/s,（0.95±0.09）m/s,（0.90±0.08）m/s and（0.85±0.07）m/s,and at 8 cm in right liver were （1.02±0.07）m/s,（0.91±0.06） m/s,（0.81±0.08）m/s and （0.72±0.05）m/s,all showing decreased ARFI value in patients with significant NASH （all P<0.05）. Conclusions ARFI quantification might be used to evaluate the liver injuries in patients with NAFLD,which needs further investigation.

Key words: Non-alcoholic fatty liver disease, Non-alcoholic steatohepatitis, Ultrasonography, Acoustic radiation force impulse technique, Diagnosis

符亮, 吴冬冰, 纪新尊, 万鸿兴, 李文刚, 饶卉明, 钟静, 江婷婷. 超声定量评估非酒精性脂肪性肝病患者肝脏ARFI值对显著NASH的诊断价值分析[J]. 实用肝脏病杂志, 2019, 22(3): 377-380.

Fu Liang, Wu Dongbing, Ji Xinzun. Application of ARFI quantification in the evaluation of liver injuries in patients with non-alcoholic fatty liver disease[J]. JOURNAL OF PRACTICAL HEPATOLOGY, 2019, 22(3): 377-380.

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