实用肝脏病杂志 ›› 2023, Vol. 26 ›› Issue (4): 524-527.doi: 10.3969/j.issn.1672-5069.2023.04.018

• 肝硬化 • 上一篇    下一篇

瞬时弹性成像检查肝组织硬度诊断酒精性肝硬化效能研究*

陈丽, 郭明君, 操依含, 曹秀玲, 周静   

  1. 430400 武汉市新洲区人民医院超声影像科(陈丽,郭明君,操依含,曹秀玲);新疆医科大学第四附属医院腹部超声科(周静)
  • 收稿日期:2023-02-27 出版日期:2023-07-10 发布日期:2023-07-21
  • 作者简介:陈丽,女,49岁,大学本科,主管技师。研究方向:主要从事超声诊断研究。E-mail:18971125151@163.com
  • 基金资助:
    *湖北省自然科学基金资助项目(编号:2021CFB331)

Clinical utility of transient elastic imaging for the detection and quantification of liver fibrosis in patients with alcoholic liver cirrhosis diagnosed by histopathology

Chen Li, Guo Mingjun, Cao Yihan, et al   

  1. Department of Ultrasound, District People's Hospital, Xinzhou, Wuhan 430400, Hubei Province, China
  • Received:2023-02-27 Online:2023-07-10 Published:2023-07-21

摘要: 目的 探讨使用瞬时弹性成像检查肝组织硬度诊断酒精性肝病(ALD)患者肝硬化的效能。 方法 2019年1月~2022年1月我院收治的ALD患者68例,均接受肝活检组织病理学检查,使用FibroScan 530 Compact诊断仪行肝硬度检测(LSM)和脾硬度检测(SSM)。采用Kappa检验两种诊断方法结果的一致性。 结果 以LSM诊断无或轻度肝纤维化28例(41.2%),显著性肝纤维化19例(27.9%),进展性肝纤维化13例(19.1%),肝硬化8例(11.8%);组织病理学诊断显示,S0、S1、S2、S3、S4期患者分别为15例(22.1%)、11例(16.2%)、20例(29.4%)、12例(17.6%)和10例(14.7%);以瞬时弹性成像诊断标准,8例肝硬化患者LSM和SSM分别为(18.4±5.6)kPa和(22.6±4.6)kPa,显著大于60例无肝硬化患者【分别为(10.7±3.3)kPa和(14.9±3.8)kPa,P<0.05】;以组织病理学检查结果为金标准,瞬时弹性成像诊断ALD患者存在肝硬化的灵敏度为70.0%,特异度为98.3%,准确率为94.1%,与组织病理学检查结果的一致性较好(Kappa值为0.744)。 结论 采用瞬时弹性成像技术检查诊断ALD患者肝硬化有较高的准确性,不失为较好的无创诊断技术而应用于临床。

关键词: 肝硬化, 酒精性肝病, 瞬时弹性成像, 肝活检, 诊断

Abstract: Objective This study was aimed to investigate the clinical utility of transient elastic (TE) imaging for the detection and quantification of liver fibrosis (LF) in patients with alcoholic liver cirrhosis diagnosed by histopathology. Methods 68 patients with alcoholic liver diseases (ALD) were encountered in our hospital between January 2019 and January 2022, and all underwent ultrasound-guided liver biopsy and TE imaging detection for liver stiffness measurement (LSM) and spleen stiffness measurement (SSM). The consistency of diagnosis by two methods was evaluated by Kappa. Results Based on the LSM, the patients without or mild LF were found in 28 cases (41.2%), with significant LF in 19 cases (27.9%), with advanced LF in 13 cases (19.1%) and liver cirrhosis (LC) in 8 cases (11.8%); the liver histopathological examination showed LF S0, S1, S2, S3 and S4 in 15 cases(22.1%), 11 cases (16.2%), 20 cases (29.4%), 12 cases (17.6%) and 10 cases (14.7%); the LSM and SSM in 8 patients with LC proven by TE were (18.4±5.6)kPa and (22.6±4.6)kPa, significantly greater than [(10.7±3.3)kPa and (14.9±3.8)kPa, respectively, P<0.05] in 60 patients without LC; based on the gold criteria by histopathology, the sensitivity, specificity and accuracy by TE in predicting LC were 70.0%, 98.3% and 94.1%, with good consistency (Kappa=0.744). Conclusion The TE imaging technique, as a good non-invasive approach, could be utilized in clinical practice for early diagnosis of LF and/or LC, which might be helpful for clinicians making interventional strategy.

Key words: Liver cirrhosis, Alcoholic liver diseases, Transient elastic imaging, Liver biopsy, Diagnosis