超声剪切波弹性成像技术评估CCl4诱导的肝损伤大鼠肝纤维化程度效能研究

doi:10.3969/j.issn.1672-5069.2023.04.006

摘要/Abstract

摘要： 目的探讨剪切波弹性成像(SWE)评估肝损伤大鼠肝纤维化程度的价值。方法将52只SD大鼠随机分为对照组12只和实验组40只,采用CCl₄腹腔注射诱导肝损伤模型,分别实验4 w、6 w、8 w和10 w,后者每个时段10只。在实验结束前,在麻醉状态下采用SWE行肝脏硬度检测(LSMs),常规进行血生化和血液检查,计算天冬氨酸氨基转移酶(AST)/血小板(PLT)比率指数(APRI)和肝纤维化-4因子指数(FIB-4)。在处死动物后立即行LSMd检测,常规进行肝组织病理学检查。应用受试者工作特征曲线(ROC)评估各指标诊断显著性肝纤维化的效能。结果肝组织病理学检查诊断大鼠F0/F1期非显著性肝纤维化18只,≥ F2显著性肝纤维化30只;非显著性肝纤维化组APRI评分为(0.05±0.02),显著低于显著组【(0.14±0.12),P＜0.05】,FIB-4评分为(0.13^-100±0.09^-100),显著低于显著组【(0.25^-100±0.13^-100),P＜0.05】,LSMs为(5.2±1.7))kPa,显著低于显著组【(9.7±2.8)kPa,P＜0.05】,LSMd为(3.6±0.8))kPa,显著低于显著组【(8.8±1.7)kPa,P＜0.05】;LSMs和LSMd诊断显著性肝纤维化的曲线下面积分别为0.91和0.93,显著大于APRI(0.75,P＜0.05)或FIB-4(0.69,P＜0.05),其诊断的敏感度和特异度分别为76.7%和87.5%,及85.7%和92.0%。结论采用SWE检测肝硬度评估肝损伤大鼠显著性肝纤维化具有较高的诊断效能,操作简便,准确率高,可重复性强,值得探讨应用。

关键词: 肝纤维化, 剪切波弹性成像, 肝脏硬度检测, 诊断, 大鼠

Abstract: Objective The aim of this study was to explore the evaluation of significant liver fibrosis (SLF) by ultrasonic shear wave elastography (SWE) in rats with carbon tetrachloride(CCl₄)-induced liver injury. Methods 52 male SD rats were randomly divided into control group (n=12) and experimental group (n=40). The liver injury model was induced by intraperitoneal injection of carbon tetrachloride for 4, 6, 8 and 10 weeks, with 10 rats sacrificed at each time. At end of each experiment, the rats were anesthetized for liver stiffness measurement (LSMs) by SWE. The blood routine and serum biochemical parameters were obtained for calculation of APRI and FIB-4. The LSM immediately after dead (LSMd) was performed again after execution. The liver fibrosis, steatosis and inflammatory activity were evaluated by pathological examination. The receiver operating characteristic (ROC) curve was applied to evaluate the performance of parameters in the diagnosis of SLF. Results The pathological examination showed F0/F1 non-significant LF(NSLF) in 18 rats, and > F2 SLF in 30 rats; the APRI score in rats with NSLF was (0.051±0.023), significantly lower than [(0.135±0.117), P<0.05], and the FIB-4 score was (0.132^-100±0.088^-100), significantly lower than [(0.245^-100±0.125^-100), P<0.05], the LSMs was(5.2±1.7)kPa, significantly lower than [(9.7±2.8)kPa, P<0.05] and the LSMd was (3.6±0.8) kPa, significantly lower than [(8.8±1.7) kPa, P<0.05] in rats with SLF; the areas under the ROC curve (AUC) by LSMs and LSMd in predicting SLF were 0.91 and 0.93, significantly higher than 0.75 by APRI or 0.69 by FIB-4, with the sensitivities and specificities of 76.7% and 87.5%, and 85.7% and 92.0%, respectively. Conclusion The SWE technique has a high clinical value in evaluating LF in rats with CCl₄-induced liver injury, with the advantages of non-invasive, simple and repeatable feature.

Key words: Liver fibrosis, Shear wave elastography, Liver stiffness measurement, Diagnosis, Rats

石莹, 吕永燕, 杨增娣, 刘波, 娄方明, 徐军, 童清平. 超声剪切波弹性成像技术评估CCl₄诱导的肝损伤大鼠肝纤维化程度效能研究[J]. 实用肝脏病杂志, 2023, 26(4): 476-479.

Shi Ying, Lyu Yongyan, Yang Zengdi, et al. Evaluation of significant liver fibrosis by ultrasonic shear wave elastography in rats with carbon tetrachloride-induced liver injury[J]. Journal of Practical Hepatology, 2023, 26(4): 476-479.

参考文献

[1] 廖月,何毅怀,罗亚文.氧化应激在急性肝损伤中的作用.临床肝胆病杂志,2022,38(10):2402-2407.
[2] Björnsson ES.Epidemiology, predisposing factors, and outcomes of drug-induced liver injury. Clin Liver Dis, 2020,24(1):1-10.
[3] 中华医学会超声医学分会介入超声学组弹性成像评估肝纤维化专家组.二维剪切波弹性成像评估慢性乙型肝炎肝纤维化临床应用指南.中华超声影像学杂志,2017,26(11):921-927.
[4] Dietrich CF, Bamber J, Berzigotti A, et al. EFSUMB guidelines and recommendations on the clinical use of liver ultrasound elastography, update 2017 (long version). Ultraschall Med, 2017,38(4):e16-e47.
[5] Ferraioli G, Wong VW, Castera L, et al. Liver ultrasound elastography: an update to the world federation for ultrasound in medicine and biology guidelines and recommendations. Ultrasound Med Biol,2018 ,44(12):2419-2440.
[6] Barr RG, Ferraioli G, Palmeri ML, et al. Elastography assessment of liver fibrosis: society of radiologists in ultrasound consensus conference statement. Ultrasound Q, 2016 ,32(2):94-107.
[7] Barr RG, Wilson SR, Rubens D, et al. Update to the society of radiologists in ultrasound liver elastography consensus statement. Radiology,2020,296(2):263-274.
[8] Saftoiu A, Gilja OH, Sidhu PS, et al. The EFSUMB guidelines and recommendations for the clinical practice of elastography in non-hepatic applications: update 2018. Ultraschall Med, 2019,40(4):425-453.
[9] European association for the study of the liver. EASL clinical practice guidelines on non-invasive tests for evaluation of liver disease severity and prognosis - 2021 update. J Hepatol, 2021,75(3):659-689.
[10] McGill MR, Jaeschke H. Animal models of drug-induced liver injury. Biochim Biophys Acta Mol Basis Dis, 2019,1865(5):1031-1039.
[11] Unsal V, Cicek M, Sabancilar İ. Toxicity of carbon tetrachloride, free radicals and role of antioxidants. Rev Environ Health, 2020;36(2):279-295.
[12] Kong W, Tang Y, Liu L, et al. Stratifying non-alcoholic steatohepatitis with the non-invasive ultrasound markers shear wave dispersion slope and shear wave velocity: an animal study. Ultrasound Med Biol, 2022,48(12):2442-2448.
[13] Kaur G, Shivanandappa TB, Kumar M, et al. Fumaric acid protect the cadmium-induced hepatotoxicity in rats: owing to its antioxidant, anti-inflammatory action and aid in recast the liver function. Naunyn Schmiedebergs Arch Pharmacol, 2020,393(10):1911-1920.
[14] Rivière B, Jaussent A, Macioce V, et al. The triglycerides and glucose (TyG) index: a new marker associated with nonalcoholic steatohepatitis (NASH) in obese patients. Diabetes Metab, 2022,48(4):101345.
[15] Zhou F, Stueck A, McLeod M. Liver biopsy complication rates in patients with non-alcoholic fatty liver disease. Can Liver J, 2022 ,5(2):106-112.
[16] 吴冬秋,崔丽华,熊峰,等.血清IL-34联合超声弹性成像诊断慢性乙型肝炎患者肝纤维化的效能分析.实用肝脏病杂志,2021,24(1):23-26.
[17] Dietrich CF, Bamber J, Berzigotti A, et al. EFSUMB guidelines and recommendations on the clinical use of liver ultrasound elastography, update 2017 (short version). Ultraschall Med, 2017,38(4):377-394.
[18] Kazemirad S, Zhang E, Nguyen BN, et al. Detection of steatohepatitis in a rat model by using spectroscopic shear-wave US elastography. Radiology, 2017,282(3):726-733.
[19] Soh EG, Lee YH, Kim YR, etal. Usefulness of 2D shear wave elastography for the evaluation of hepatic fibrosis and treatment response in patients with autoimmune hepatitis. Ultrasonography,2022,41(4):740-749.
[20] 池肇春.药物性肝损伤研究现状与进展.世界华人消化杂志,2021,29(16):915-925.
[21] 杨艳秋,程颢,冯敏.肝脏剪切波弹性成像对慢性乙型肝炎患者肝纤维化的评估价值.实用肝脏病杂志,2021,24(4):480-483.
[22] Li Q, Wu Y, Zhu Q, et al. External validation of Liaoning score for predicting esophageal varices in liver cirrhosis: a Chinese multicenter cross-sectional study. Ann Transl Med, 2019,7(23):755.
[23] Yang R, Gui X, Ke H,et al. Accuracy of FIB-4 and APRI scores compared to transient elastography for liver fibrosis in patients with HIV and HBV co-infection. Int J STD AIDS, 2023,34(1):18-24.

超声剪切波弹性成像技术评估CCl₄诱导的肝损伤大鼠肝纤维化程度效能研究

Evaluation of significant liver fibrosis by ultrasonic shear wave elastography in rats with carbon tetrachloride-induced liver injury

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