目的探讨实时剪切波和实时组织超声弹性成像技术对胆道闭锁(BA)和婴儿肝炎综合征(IHS)肝脏弹性改变。方法应用实时剪切波和实时组织超声弹性成像技术对23例BA患儿、44例IHS患儿和20正常婴儿进行检查,分别统计各组肝脏弹性杨氏模量值和弹性评分,对各组肝脏弹性杨氏模量值和弹性评分进行对比分析。结果 BA组、IHS组和正常对照组肝脏杨氏模量平均值分别为(15.79±6.71)kPa、(8.15±2.45)kPa、(5.63±0.67)kPa,三组之间差异有统计学意义(F=35.39、27.86,P<0.05)。SWE和RTE技术鉴别BA组和淤胆型组的最佳阈值分别为10.77kPa和2.5分,灵敏度、特异度和曲线下面积分别为73.9%、87.0%、0.811(0.679~0.943)和56.5%、87.0%、0.756(0.656~0.917),灵敏度和曲线下面积SWE技术大于RTE技术(P<0.05),差异有统计学意义。结论 SWE技术结果读取更简单直观、更易于临床推广应用,可帮助临床医师鉴别BA和IHS提供肝脏硬度信息。 Objective To investigate the change of liver elasticity of biliary atresia (BA) and infantile hepatitis syndrome (IHS) by real-time shear wave and real-time tissue elastography. Methods Twenty-three cases of BA, 44 cases of IHS and 20 normal infants were examined by real-time shear wave and real-time tissue elastography. The elastic Young’s modulus and elastic score of each group were calculated, Liver elastic Young’s modulus value and elastic score comparative analysis. Results The average Young’s modulus of liver in BA group, IHS group and normal control group were (15.79 ± 6.71) kPa, (8.15 ± 2.45) kPa and (5.63 ± 0.67) kPa, respectively. The differences among the three groups were statistically significant F = 35.39, 27.86, P <0.05). The best thresholds for the identification of BA and cholestasis group by SWE and RTE were 10.77kPa and 2.5, respectively, and the sensitivity, specificity and area under the curve were 73.9%, 87.0%, 0.811 (0.679-0.943) and 56.5% respectively, 87.0% and 0.756 (0.656-0.917) respectively. The sensitivity and the area under the curve were higher than those of RTE (P <0.05), and the difference was statistically significant. Conclusion The results of SWE are simpler and more intuitive to read and easier to popularize. It can help clinicians identify liver hardness information from BA and IHS.