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目的评估声脉冲辐射成像技术(ARFI)在早期非酒精性脂肪性肝炎(NASH)诊断中的应用价值。方法采用随机数字表法将32只SD大鼠随机分为普通饲料组(n=8)和高脂饲料组(n=24),分别于4、8、12、16周末从高脂饲料组及普通饲料组随机抽取6只及2只行体质量、血生化、常规超声及ARFI检测,处死后取大鼠肝脏行HE染色,观察病理。结果 32只大鼠均未出现肝纤维化,根据病理结果分为M1组[轻中度单纯性脂肪肝(SS)]、M2组(重度SS)、M3组(重度SS合并早期NASH)和C组(正常对照)4组,早期NASH仅出现在重度脂肪肝组,其分布差异有统计学意义(P=0.006)。常规超声诊断脂肪肝程度与病理检查结果的符合率为34.4%(11/32)。M3组的ARFI值为(1.16±0.04)m/s,明显低于M2组的(1.22±0.05)m/s(t=2.301,P=0.04);M3组的LDL-C为(1.53±0.07)mmol/L,明显高于M2组的(1.21±0.22)mmol/L(t=3.075,P=0.01);两组大鼠在三酰甘油、总胆固醇、高密度脂蛋白、谷草转氨酶、谷丙转氨酶和体质量方面差异均无统计学意义(P均>0.05)。结论早期NASH的出现与脂肪肝程度相关。ARFI值可为重度SS患者是否合并早期NASH提供重要信息。
Objective To evaluate the value of acoustic pulse radiography (ARFI) in the diagnosis of early non-alcoholic steatohepatitis (NASH). Methods Twenty-two SD rats were randomly divided into normal diet group (n = 8) and high fat diet group (n = 24) by random number table method. At the end of 4, 8, The normal diet group were randomly selected 6 and 2 body weight, blood biochemical, routine ultrasound and ARFI detection, after sacrifice rats liver HE staining, pathological observation. Results There were no liver fibrosis in all the 32 rats. According to the pathological results, they were divided into M1 group [mild to moderate simple fatty liver (SS)], M2 group (severe SS), M3 group (severe SS with early NASH) Group 4 (normal control), early NASH only appeared in severe fatty liver group, the difference was statistically significant (P = 0.006). The coincidence rate of routine ultrasonic diagnosis of fatty liver and pathological examination results was 34.4% (11/32). (1.16 ± 0.04) m / s in M3 group was significantly lower than that in M2 group (1.22 ± 0.05) m / s (t = 2.301, P = 0.04); the LDL-C in M3 group was (1.53 ± 0.07) ) mmol / L was significantly higher than that of M2 group (1.21 ± 0.22 mmol / L, t = 3.075, P = 0.01) There was no significant difference in ALT and body weight (P> 0.05). Conclusion The occurrence of early NASH is related to the degree of fatty liver. The ARFI value may provide important information as to whether severe SS patients have early NASH or not.