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目的探讨声触诊组织量化技术(virtual touch tissue quantification,VTQ),诊断酒精性肝病(alcoholic liver disease,ALD)早期硬化的价值。方法采用VTQ技术对2013年5月—2015年9月于杭州市西溪医院就诊的3组154例受检者(酒精性肝病组63例、早期酒精性肝硬化组41例及健康对照组50例)进行肝脏右叶弹性检测并记录。所有患者均于检测一周后,行肝脏穿刺活检,以病理检查为金标准,比较VTQ技术对早期酒精性肝硬化的诊断价值。通过受试者工作特征曲线(receiver operating characteristic curve,ROC)分析确定界值。结果对照组、酒精性肝病组及早期酒精性肝硬化组的VTQ值分别为(1.14±0.14)m/s、(1.48±0.27)m/s、(2.33±0.48)m/s。两两组间比较VTQ值差异有统计学意义(P<0.001),VTQ技术诊断酒精性肝病早期肝硬化组的ROC曲线下面积为0.955。鉴别酒精性肝病和早期硬化的VTQ界值为1.78 m/s,其诊断的敏感度(sensitivity,Se)和特异度(specificity,Sp)分别为85.7%和95.1%。结论 VTQ技术能够定量反映肝组织的硬度,对诊断早期酒精性肝硬化有较高的价值。
Objective To investigate the value of virtual touch tissue quantification (VTQ) in diagnosing early-stage hardening of alcoholic liver disease (ALD). Methods Three groups of 154 subjects (alcoholic liver disease group, 63 cases, 41 cases of early alcoholic cirrhosis group and 50 cases of healthy control group) were treated with VTQ technique from May 2013 to September 2015 in Hangzhou Xixi Hospital. ) Right liver lobe elasticity test and record. All patients underwent liver biopsy one week after the test. The pathological examination was taken as the gold standard to compare the diagnostic value of VTQ for early alcoholic cirrhosis. The cutoff value was determined by receiver operating characteristic curve (ROC) analysis. Results The VTQ of control group, alcoholic liver disease group and early alcoholic cirrhosis group were (1.14 ± 0.14) m / s, (1.48 ± 0.27) m / s and (2.33 ± 0.48) m / s, respectively. The difference of VTQ between the two groups was statistically significant (P <0.001). The area under the ROC curve of VTQ for diagnosis of alcoholic liver disease was 0.955. The VTQ cutoff value for identifying alcoholic liver disease and early sclerosis was 1.78 m / s, with diagnostic, sensitivity and specificity of 85.7% and 95.1%, respectively. Conclusion VTQ can quantitatively reflect the hardness of liver tissue and is of high value in the diagnosis of early stage alcoholic liver cirrhosis.