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目的:探讨声脉冲辐射力成像(ARFI)技术在不同程度脂肪肝中的诊断价值,分析剪切波波速与各生化指标的关联性,为临床干预提供参考。方法:选取2015年3月来我院做健康体检诊断为脂肪肝的106例患者和30例健康者,根据脂肪肝程度分为4组,即A组(健康者)、B组(脂肪肝轻度)、C组(脂肪肝中度)和D组(脂肪肝重度),采用声触诊组织量化技术分别测量各组肝脏剪切波波速,并检测总胆固醇(TC)、甘油三酯(TG)、天冬氨酸转氨酶(AST)、丙氨酸氨基转移酶(ALT)、高密度脂蛋白胆固醇(HDL-C)及低密度脂蛋白胆固醇(LDL-C)。结果:A、B、C、D组剪切波波速分别为(1.04±0.12)、(1.08±0.08)、(1.31±0.18)、(0.78±0.11)m·s~(-1),C组波速最高,D组波速最低,B组与A组间波速差异无统计学意义(P>0.05),C、D组与A组间波速差异有统计学意义(P<0.05)。B、C组TC、TG、AST、ALT、LDL-C与波速呈正相关(P<0.05),HDL-C与波速呈负相关(P<0.05)。结论:ARFI技术可以更准确诊断脂肪肝,剪切波波速与相关生化指标有良好相关性,值得临床推广。
Objective: To investigate the diagnostic value of acoustic pulse radiofrequency imaging (ARFI) in fatty liver of varying degrees and to analyze the correlation between the shear wave velocity and various biochemical parameters, so as to provide a reference for clinical intervention. Methods: A total of 106 patients and 30 healthy people diagnosed as fatty liver in our hospital from March 2015 were selected and divided into 4 groups according to the degree of fatty liver: group A (healthy), group B (fatty liver (Group C) (moderate fatty liver) and group D (severe fatty liver). The shear wave velocity of liver in each group was measured by acoustic palpation. The levels of total cholesterol (TC), triglyceride ), AST, ALT, HDL-C and LDL-C, respectively. Results: The shear wave velocities in groups A, B, C and D were (1.04 ± 0.12), (1.08 ± 0.08), (1.31 ± 0.18) and (0.78 ± 0.11) m · s ~ The wave velocity was the highest in group D, the lowest in group D, and there was no significant difference in wave velocity between group B and group A (P> 0.05). The difference of wave velocity was statistically significant between group C and group D (P <0.05). The levels of TC, TG, AST, ALT and LDL-C in group B and C were positively correlated with the wave velocity (P <0.05). The HDL-C was negatively correlated with the wave velocity (P <0.05). Conclusion: ARFI can diagnose fatty liver more accurately. The shear wave velocity has good correlation with related biochemical indexes, which is worthy of clinical promotion.