关键词: 慢性乙型肝炎, 肝硬化, 超声半定量评分, 超声弹性成像, 肝脏硬度检测, 诊断

Abstract: Objective The aim of this study was to investigate the diagnostic performance of ultrasound semi-quantitative score and elastography combination in the diagnosis of early cirrhosis in patients with chronic hepatitis B (CHB). Methods 112 patient with CHB were admitted to our hospital between March 2017 and May 2022, and all patients underwent liver biopsies and ultrasonography. The liver stiffness measurement (LSM) and ultrasound semi-quantitative scores were recorded. The diagnostic performance of ultrasound semi-quantitative score and LSM combination for early cirrhosis was evaluated with the area under the receiver operating characteristic (ROC) curve (AUC). Results The liver histopathological examination found early liver cirrhosis in 18 cases; the scores of liver parenchymal echo, liver capsule, hepatic vein clarity, marginal morphology, spleen thickness and the total score by ultrasound semi-quantitation in patients with early cirrhosis were(2.4±0.4), (2.1±0.6), (2.2±0.4), (2.6±0.4), (2.3±0.4) and (11.6±2.4), significantly higher than [(1.7±0.3),(1.5±0.3), (1.7±0.3), (1.5±0.4), (1.7±0.3) and (8.1±1.6), respectively, P<0.05] in patients with CHB; the LSM in patients with cirrhosis was (12.5±2.8)kPa, much greater than [(8.7±2.1)kPa, P<0.05] in patients with CHB; the AUC of ultrasound semi-quantitative score, LSM and combination of the two in the diagnosis of early cirrhosis were 0.826(95% CI:0.747-0.905), 0.863(95% CI:0.794-0.932) and 0.931(95% CI:0.881-0.981), showing the latter greatly superior to the parameter of the two alone (P<0.05); the sensitivity and specificity of the combination prediction were 88.9% and 91.4%, respectively. Conclusion The non-invasive diagnosis of early liver cirrhosis by ultrasound semi-quantitative score elastography in patients with CHB has a high efficacy, and warrants clinical application.

Key words: Hepatitis B, Cirrhosis, Ultrasound semi-quantitative score, Elastography, Liver stiffness measurement, Diagnosis