论文部分内容阅读
目的探讨肝细胞外基质体积分数(f ECVs)在无创定量评价肝纤维化程度方面的诊断价值。方法选取肝脏穿刺确诊肝纤维化并进行常规肝脏多期动态增强CT扫描患者60例,通过平扫及平衡期(注射对比剂3 min后)计算肝实质(Eliver)及主动脉(Eaorta)绝对强化值,并通过以下公式计算f ECV值:f ECV(%)=Eliver/Eaorta(100-Hct[%]),分析各纤维化组间f ECV值差异及其与肝脏纤维化程度的相关性,采用受试者工作特征曲线分析f ECV值诊断肝纤维化程度的能力。结果肝纤维化分期组间f ECV值比较差异具有统计学意义(P<0.05),S0∶S4、S1∶S4及S2∶S4差异有统计学意义;f ECV值与肝纤维化程度呈正相关(r=0.468,P=0.001);f ECV值诊断重度肝纤维化及早期肝硬化(S≥3及S=4)的敏感性和特异性分别为76%、68%及89%、63%,受试者工作特征曲线下面积分别为0.757及0.775。结论 f ECV值可以作为常规肝脏多期动态增强CT检查中无创性评估肝纤维化的方法。
Objective To investigate the diagnostic value of extracellular matrix volume fraction (f ECVs) in noninvasive quantitative evaluation of liver fibrosis. Methods Liver fibrosis was diagnosed by liver biopsy in 60 patients with routine liver multi-phase dynamic contrast-enhanced CT scan. Absolute enhancement of Eliver and Eaorta was calculated by plain and equilibrium (3 min after contrast injection) Value and the fECV value was calculated by the following formula: f ECV (%) = Eliver / Eaorta (100-Hct [%]), analyzing the difference of f ECV values between each fibrosis group and its correlation with the degree of liver fibrosis, The receiver operating characteristic curve was used to analyze the ability of f ECV to diagnose the degree of liver fibrosis. Results There was significant difference in f ECV between staging groups (P <0.05), and the difference of S0: S4, S1: S4 and S2: S4 was statistically significant. The value of fECV was positively correlated with the degree of liver fibrosis r = 0.468, P = 0.001). The sensitivity and specificity of f ECV in diagnosis of severe liver fibrosis and early cirrhosis (S≥3 and S = 4) were 76%, 68% and 89% The area under the receiver operating characteristic curve was 0.757 and 0.775, respectively. Conclusion The f ECV value can be used as a noninvasive method to evaluate hepatic fibrosis in multi-phase dynamic contrast-enhanced CT.