超声衰减系数成像评估儿童和青少年肝豆状核变性肝损害应用研究*

doi:10.3969/j.issn.1672-5069.2026.05.015

摘要/Abstract

摘要： 目的分析超声衰减系数成像(ATI)评估儿童和青少年肝豆状核变性(HLD)肝脏损害的价值。方法 2021年2月～2024年2月我院收治的HLD患者60例,其中Child-Pugh A级38例、B级13例和C级9例。使用迈瑞多参数超声诊断仪测量超声衰减系数成像(ATT),使用Fibroscan行肝脏硬度检测(LSM),应用受试者工作特征曲线(ROC)分析指标的诊断效能。结果 Child-Pugh C级患者LSM、ATI、肝纤维化-4因子(Fib-4)和天冬氨酸氨基转移酶与血小板比值指数(APRI)分别为(16.6±3.3)kPa、(0.8±0.3)dB/cm/MHz、(1.4±0.6)和(0.4±0.2),均显著高于B级【分别为(11.0±2.2)kPa、(0.6±0.2)dB/cm/MHz、(1.0±0.5)和(0.3±0.1),P<0.05】或A级【分别为(7.1±1.2)kPa、(0.4±0.1)dB/cm/MHz、(0.7±0.3)和(0.2±0.1),P<0.05】; 经ROC分析,ATI和LSM诊断Child-Pugh B/C级HLD的AUC分别为0.88和0.90,均显著优于Fib-4的0.74或APRI的0.72。结论应用ATI评估儿童和青少年HLD患者中重度肝损害可以达到LSM的诊断水平,临床可根据实际情况选择应用。

关键词: 肝豆状核变性, 超声衰减系数成像, 肝硬度检测, 诊断, 儿童/青少年

Abstract: Objective The purpose of this study was to investigate ultrasound attenuation coefficient imaging (ATI) in the evaluation of liver damage in children and adolescents with hepatolenticular degeneration (HLD). Methods Sixty children and adolescents with HLD, including Child class A in 38 cases, Child class B in 13 cases and Child class C in 9 cases, were encountered in our hospital between February 2021 and February 2024, and all underwent ultrasound attenuation coefficient and elastography imaging for ATI and liver stiffness measurement (LSM). The receiver operating characteristic (ROC) curve was applied to assess diagnostic performance of liver damage. Results LSM, ATI, Fib-4 and APRI in patients with Child-Pugh class C were (16.6±3.3)kPa, (0.8±0.3)dB/cm/MHz, (1.4±0.6) and (0.4±0.2), all significantly higher than [(11.0±2.2)kPa, (0.6±0.2)dB/cm/MHz, (1.0±0.5) and (0.3±0.1), respectively, P<0.05] in those with Child class B or [(7.1±1.2)kPa, (0.4±0.1)dB/cm/MHz, (0.7±0.3) and (0.2±0.1), respectively, P<0.05] in those with Child class A; ROC analysis showed that the AUCs were 0.88 and 0.90, respectively, when ATI and LSM were applied to predict severe liver injuries of Child-Pugh class B/C in patients with HLD, both much superior to 0.74 by Fib-4 or 0.72 by APRI. Conclusion ATI and LSM have a high diagnostic efficacy in the evaluation of liver damage in children and adolescents with HLD, and clinicians might select one of them to assess.

Key words: Hepatolenticular degeneration, Ultrasound attenuation coefficient imaging, Liver stiffness measurement, Diagnosis, Children, Adolescents

王海玉, 张志博, 王倩, 刘翠翠, 王燕妮. 超声衰减系数成像评估儿童和青少年肝豆状核变性肝损害应用研究^*[J]. 实用肝脏病杂志, 2026, 29(5): 697-700.

Wang Haiyu, Zhang Zhibo, Wang Qian, et al. Ultrasound attenuation coefficient imaging in the assessment of liver damage in children and adolescents with hepatolenticular degeneration[J]. Journal of Practical Hepatology, 2026, 29(5): 697-700.

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超声衰减系数成像评估儿童和青少年肝豆状核变性肝损害应用研究^*

Ultrasound attenuation coefficient imaging in the assessment of liver damage in children and adolescents with hepatolenticular degeneration

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