超声受控衰减参数与二维超声剪切波弹性成像评估代谢功能障碍相关脂肪性肝病患者肝纤维化效能比较*

doi:10.3969/j.issn.1672-5069.2026.02.014

实用肝脏病杂志 ›› 2026, Vol. 29 ›› Issue (2): 217-220.doi: 10.3969/j.issn.1672-5069.2026.02.014

超声受控衰减参数与二维超声剪切波弹性成像评估代谢功能障碍相关脂肪性肝病患者肝纤维化效能比较^*

吴娟, 段艳, 乞艳华

710065 西安市陕西省康复医院影像二科(吴娟);陕西省第二人民医院功能科彩超室(段艳);西安交通大学第二附属医院超声科(乞艳华)

收稿日期:2025-03-12 出版日期:2026-03-10 发布日期:2026-03-13
通讯作者: 段艳,E-mail:dyan1108@163.com
作者简介:吴娟,女,44岁,大学本科,主治医师。E-mail:happy_wu81@163.com
基金资助:
^*陕西省科技厅重点科研计划项目(编号:2021SF-015)

Comparison of diagnostic efficacy of transient elastography to two-dimensional shear wave elastography in assessing significant liver fibrosis in patients with metabolic dysfunction-associated fatty liver disease

Wu Juan, Duan Yan, Qi Yanhua

Second Section, Department of Radiology, Kangfu Hospital, Xi'an 710065, Shaanxi Province, China

Received:2025-03-12 Online:2026-03-10 Published:2026-03-13

摘要/Abstract

摘要： 目的比较研究弹性成像与二维超声剪切波弹性成像(2D-SWE)评估代谢功能障碍相关脂肪性肝病(MAFLD)患者肝纤维化的效能。方法 2022年3月～2024年10月我院诊治的110例MAFLD患者,均接受肝活检,使用Fibrotouch行肝脏硬度检测(LSM)和受控衰减参数(CAP),使用2D-SWE检测杨氏模量值。应用受试者工作特征(ROC)曲线评估诊断效能。结果在110例MAFLD患者中,肝组织病理学检查诊断代谢相关性单纯性脂肪肝(MRSFL)62例和代谢相关性脂肪性肝炎(MASH)48例,其中F2期肝纤维化30例,F3期15例,F4期3例;MASH组血清总胆固醇、甘油三酯、低密度脂蛋白和丙氨酸氨基转移酶水平均显著高于,而血清高密度脂蛋白水平显著低于MRSFL组,差异均具有统计学意义(P<0.05); MASH组CAP、LSM和杨氏模量值分别为(315.2±20.6)dB/m、(12.0±2.3)kPa和(10.1±2.1)kPa,均显著高于MRSFL组【分别为(267.8±8.4)dB/m、(5.9±1.4)kPa和(4.9±1.4)kPa,P<0.05】;ROC曲线分析结果表明,LSM诊断显著性肝纤维化的AUC为0.899(95%CI:0.831～0.987),其敏感性为0.888,特异性为0.826,而杨氏模量值也具有较好的诊断效能(AUC为0.885,95%CI:0.822～0.949,敏感性为0.796,特异性为0.806)。结论使用LSM或2D-SWE检测诊断MAFLD患者显著性肝纤维化均具有很大的临床应用价值。

Abstract: Objective The aim of this study was to compare diagnostic efficacy of transient elastography (TE) to two-dimensional shear wave elastography (2D-SWE) in assessing significant liver fibrosis (SLF) in patients with metabolic dysfunction-associated fatty liver disease (MAFLD). Methods A total of 110 patients with MAFLD were encountered in our hospital between March 2022 and October 2024, and all underwent liver biopsies. TE was performed to obtain liver stiffness measurement (LSM) and controlled attenuation parameter (CAP), and Young's modulus was obtained by 2D-SWE. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the diagnostic performance. Results Of the 110 patients with MAFLD, liver histo-pathological examination proven metabolic related simple fatty liver (MRSFL) in 62 cases and metabolic dysfunction-associated steatohepatitis(MASH) in 48 cases, including F2 stage of liver fibrosis in 30 cases, F3 in 15 cases and F4 in 3 cases; serum total cholesterol, triglyceride, low-density lipoprotein and alanine aminotransferase levels in patients with MASH were significantly higher, while serum high-density lipoprotein level was significantly lower than in patients with MRSFL(P<0.05); CAP, LSM and Young's modulus in patients with MASH were (315.2±20.6)dB/m, (12.0±2.3)kPa and (10.1±2.1)kPa, all much higher than [(267.8±8.4)dB/m,(5.9±1.4)kPa and (4.9±1.4)kPa, respectively, P<0.05] in those with MRSFL; ROC analysis showed that the AUC was 0.899(95%CI: 0.831-0.987), with sensitivity (Se) of 0.888 and specificity (Sp) of 0.826, when LSM was applied to predict SLF, and the AUC was 0.885 (95%CI:0.822-0.949), with Se of 0.796 and Sp of 0.806, when Young's modulus was applied. Conclusion Both LSM and 2D-SWE could help predict SLF non-invasively in patients with MAFLD, which should be a widespread tool for clinical application.

Key words: Metabolic dysfunction-associated fatty liver disease, Liver fibrosis, Transient elastography, Shear wave elastography, Diagnosis

吴娟, 段艳, 乞艳华. 超声受控衰减参数与二维超声剪切波弹性成像评估代谢功能障碍相关脂肪性肝病患者肝纤维化效能比较^*[J]. 实用肝脏病杂志, 2026, 29(2): 217-220.

Wu Juan, Duan Yan, Qi Yanhua. Comparison of diagnostic efficacy of transient elastography to two-dimensional shear wave elastography in assessing significant liver fibrosis in patients with metabolic dysfunction-associated fatty liver disease[J]. Journal of Practical Hepatology, 2026, 29(2): 217-220.

参考文献

[1] Gofton C, Upendran Y, Zheng MH, et al. MAFLD: How is it different from NAFLD? Clin Mol Hepatol,2023,29(Suppl 1):S17-S31.
[2] Gutiérrez-Cuevas J, Santos A, Armendariz-Borunda J. Pathophysiological molecular mechanisms of obesity: a link between MAFLD and NASH with cardiovascular diseases. Int J Mol Sci,2021,22(21):11629.
[3] Torres L, Schuch A, Longo L,et al. New FIB-4 and NFS cutoffs to guide sequential non-invasive assessment of liver fibrosis by magnetic resonance elastography in NAFLD. Ann Hepatol,2023,28(1):100774.
[4] 郭萌,郭琦,张峰.超声瞬时弹性成像检测受控衰减参数评估非酒精性脂肪性肝病患者肝脂肪变程度价值研究.实用肝脏病杂志,2024,27(2):189-192.
[5] 李雪齐,程广文,乔晓慧,等.多参数超声定量评估高风险脂肪性肝炎的临床价值.中华肝脏病杂志,2024,32(9):820-827.
[6] Eslam M, Newsome PN, Sarin SK,et al. A new definition for metabolic dysfunction-associated fatty liver disease: An international expert consensus statement. J Hepatol,2020,73(1):202-209.
[7] 中华医学会肝病学分会,中华医学会消化病学分会,中华医学会感染病学分会.肝纤维化诊断及治疗共识(2019年).中华肝脏病杂志,2019,27(9):657-667.
[8] Fabris L, Campello E, Cadamuro M,et al. The evil relationship between liver fibrosis and cardiovascular disease in metabolic dysfunction-associated fatty liver disease (MAFLD): Looking for the culprit. Biochim Biophys Acta Mol Basis Dis,2024,1870(3):166763.
[9] 张文利,董家琪,周柱玉,等.Fibroscan弹性值与肝纤维化标志物在肝硬化患者中的关系及预后预测价值分析.分子诊断与治疗杂志,2020,12(6):781-785.
[10] 陶贞贞,王永莉,孙红艳,等.二维剪切波弹性成像诊断慢性乙型肝炎患者肝纤维化价值研究.实用肝脏病杂志,2023,26(3):328-331.
[11] 石莹,吕永燕,杨增娣,等.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.实用肝脏病杂志,2023,26(4):476-479.
[12] 张馨悦,孝梦甦,吕珂,等.非酒精性脂肪性肝病的超声评价方法及应用现状.中华健康管理学杂志,2021,15(1):83-86.
[13] 王常鹤,朱璇,邓静,等.超声剪切波弹性成像联合AAR、APRI和FIB-4指数诊断慢性乙型肝炎患者肝纤维化程度效能研究.实用肝脏病杂志,2025,28(1):32-35.
[14] 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.
[15] 付懿铭,王春艳,李忠斌,等.受控衰减参数对非酒精性脂肪性肝病患者肝脂肪变性分级的诊断价值.解放军医学杂志,2022,47(6):593-598.
[16] 张欣媛,张诺琪,于国慧,等.脂肪因子Chemerin与肝纤维化发生发展的关系.临床肝胆病杂志,2025,41(1):164-169.
[17] 刘文怡,王建红,郭源,等.FibroScan评价脑死亡器官捐献供肝纤维化及脂肪变性程度的价值研究.中华器官移植杂志,2020,41(1):24-28.
[18] 叶细容,吕志红,江峰,等.两种超声弹性成像技术诊断慢性乙型肝炎患者肝纤维化价值比较.实用肝脏病杂志,2020,23(1):18-21.
[19] Yu H, Liu H, Zhang J,et al. Accuracy of FibroTouch in assessing liver steatosis and fibrosis in patients with metabolic-associated fatty liver disease combined with type 2 diabetes mellitus. Ann Palliat Med,2021,10(9):9702-9714.
[20] 王雪鑫,李颖霞,姜利彬,等.实时剪切波弹性成像对自身免疫性肝炎纤维化的诊断价值.临床肝胆病杂志,2023,39(1):97-103.

超声受控衰减参数与二维超声剪切波弹性成像评估代谢功能障碍相关脂肪性肝病患者肝纤维化效能比较^*

Comparison of diagnostic efficacy of transient elastography to two-dimensional shear wave elastography in assessing significant liver fibrosis in patients with metabolic dysfunction-associated fatty liver disease

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

编辑推荐

Metrics

本文评价

[1]	黄锦, 李佳豪, 徐雨轩, 刘小微, 熊思妍, 徐雨鹏, 罗英, 洪芬芳, 杨树龙. 脂多糖在代谢功能障碍相关脂肪性肝病发病机制中的作用^*[J]. 实用肝脏病杂志, 2026, 29(2): 161-166.
[2]	何红梅, 沙志虎, 邵建国, 徐姝嫣. 恩替卡韦联合软肝散结方治疗慢性乙型肝炎患者临床疗效研究^*[J]. 实用肝脏病杂志, 2026, 29(2): 179-182.
[3]	常静霞, 张丽, 盖琳, 张田龙, 郑爱兰, 郭煜. 瞬时弹性成像联合FIB-4和APRI评估慢性乙型肝炎患者肝纤维化价值研究^*[J]. 实用肝脏病杂志, 2026, 29(2): 183-186.
[4]	黄炎芳, 李远, 李政, 黎坚. 血清腱糖蛋白-C和多种肝纤维化指数诊断慢性乙型肝炎患者肝纤维化效能研究^*[J]. 实用肝脏病杂志, 2026, 29(2): 187-190.
[5]	张卉新, 隋雪梅. 声触诊组织量化技术联合其他指标诊断慢性乙型肝炎患者肝纤维化效能临床研究^*[J]. 实用肝脏病杂志, 2026, 29(2): 191-194.
[6]	张萌, 许怀利, 杨小飞, 杨湘敏, 张鹏飞. 非酒精性脂肪性肝病患者血清趋化因子CXCL12及其受体CXCR4和CXCR7水平变化临床意义研究^*[J]. 实用肝脏病杂志, 2026, 29(2): 205-208.
[7]	储茜, 景龙宵, 张力, 孙恒亮. 血清PCT、IL-26和IFN-γ水平联合MELD评分预测慢加急性乙型肝炎肝衰竭患者感染价值探讨^*[J]. 实用肝脏病杂志, 2026, 29(2): 233-236.
[8]	孙博汉, 曹春莉, 奇丽娜. MELD评分联合血清胱抑素C和ALBI评分诊断失代偿期肝硬化患者并发肝肾综合征价值研究^*[J]. 实用肝脏病杂志, 2026, 29(2): 249-252.
[9]	李军勇, 陈华, 黄毅利. 实时组织弹性成像联合APRI和FIB-4预测乙型肝炎肝硬化患者并发食管静脉曲张价值分析^*[J]. 实用肝脏病杂志, 2026, 29(2): 261-264.
[10]	刘立楠, 常宇飞, 王卉. 肝硬化并发脓毒症患者SOFA评分和MELD-Na⁺评分变化及其临床意义探讨[J]. 实用肝脏病杂志, 2026, 29(2): 273-276.
[11]	吉盛超, 耿承军, 陆泽华, 叶黛西, 冯浩, 金晓凤, 陈利华. 基于增强CT和MRI参数构建模型鉴别诊断不典型肝细胞癌与肿块型肝内胆管细胞癌价值研究^*[J]. 实用肝脏病杂志, 2026, 29(2): 281-284.
[12]	石国富, 朱志韬, 张苏波, 金怀玉. MSCT联合增强MRI鉴别诊断肝脏局灶性结节性增生与肝细胞癌价值研究^*[J]. 实用肝脏病杂志, 2026, 29(2): 301-304.
[13]	王威, 孟云, 冀鹏. 磁共振增强扫描量化参数鉴别诊断肝脏良恶性占位性病变价值研究^*[J]. 实用肝脏病杂志, 2026, 29(2): 305-308.
[14]	吴江云, 习广晓, 韩菲燕. 动态三维超声造影联合剪切波弹性成像鉴别诊断良恶性肝脏局灶性病变价值研究^*[J]. 实用肝脏病杂志, 2026, 29(2): 309-312.
[15]	焦婧然, 徐曼曼, 陈煜. 价值医疗导向的DRG支付对重症肝病诊疗的影响^*[J]. 实用肝脏病杂志, 2026, 29(1): 1-4.