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目的探讨声辐射力脉冲技术测量肝脏弹性值的影响因素。方法收集51例正常志愿者和177例慢性乙型肝炎患者的超声弹性检查结果,分析各因素对肝脏剪切波速度测量结果的准确度和稳定性的影响。结果两名医师测量一致性好(不同深度ICC均>0.90)。正常人群中,深层组、男性组和皮下组织厚度薄组测量数据稳定性更好(CV:P=0.000、0.045、0.045);中老年组剪切波速度(SWV)高于青年组(P=0.004);不同体质量指数(BMI)分组间CV有差异(P=0.046)。肝脏SWV和慢乙肝患者肝纤维化程度呈高度正相关性(Sprearmanρ=0.753,P=0.000)。轻度肝纤维化患者,男性SWV高于女性,CV低(P=0.047、0.045);中老年组SWV高于青年组(P=0.003)。中度肝纤维化患者,中老年组SWV高于青年组(P=0.009),重度纤维化患者各因素组间无统计学差异。结论应用声辐射力脉冲技术测量肝脏弹性数值,在不同人群中需考虑不同因素的影响,客观分析测量结果的意义。
Objective To investigate the influential factors of measuring liver elastic value by acoustic radiation pulse technique. Methods The echocardiographic results of 51 normal volunteers and 177 patients with chronic hepatitis B were collected and the effects of various factors on the accuracy and stability of the results of shear wave velocity measurement were analyzed. Results The two doctors had good agreement (ICC> 0.90 at different depths). In the normal population, the measurement data of the thin group of the deep group, the male group and the subcutaneous tissue are more stable (CV: P = 0.000,0.045,0.045); the shear wave velocity (SWV) of the middle-aged group is higher than that of the young group (P = 0.004). There was a significant difference in CV between different body mass index (BMI) groups (P = 0.046). There was a highly positive correlation between liver SWV and liver fibrosis in patients with chronic hepatitis B (Sprearman ρ = 0.753, P = 0.000). In patients with mild liver fibrosis, the SWV of males was higher than that of females, and the CV was low (P = 0.047, 0.045). The SWV of middle-aged and elderly patients was higher than that of young patients (P = 0.003). In patients with moderate hepatic fibrosis, SWV was higher in the middle-aged and elderly groups than in the youth group (P = 0.009). There was no significant difference among the various groups of patients with severe fibrosis. Conclusion The application of acoustic radiation pulse technique to measure the elasticity of the liver should consider the influence of different factors in different populations and objectively analyze the significance of the measurement results.