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目的:运用实时组织弹性成像(RTE)对肝脏弹性图像进行评分,并通过与实验室指标的比较,探讨RTE评分诊断肝纤维化程度的可行性与准确性。方法:选取我院收治的慢性病毒性肝炎患者90例作为研究对象,行RTE以及肝功能、血常规和凝血五项等实验室检查,随后肝活检获得病理学证据。比较RTE评分与实验室指标诊断肝纤维化程度的准确性。结果:90例患者中,S0期21例,S1期31例,S2期31例,S3期20例,S4期7例。RTE评分与肝纤维化程度呈正相关(r=0.79,P<0.05)。同样,门冬氨酸氨基转移酶/血小板比例指数(APRI)与肝纤维化程度也呈正相关(r=0.57,P<0.05)。RTE评分只与APRI呈相关性(r=0.667,P=0.000)。RTE评分诊断明显肝纤维化的敏感度为94.31%、特异度为78.65%、准确率为85.22%、阳性预测值为76.63%、阴性预测值为94.58%,均高于APRI。结论:实时组织弹性成像技术在诊断肝纤维化方面有广泛的临床研究价值和前景。
OBJECTIVE: To evaluate the feasibility and accuracy of RTE in diagnosing liver fibrosis by using real-time tissue elastography (RTE) to evaluate liver elastic images and comparing with laboratory indexes. Methods: Totally 90 patients with chronic viral hepatitis admitted to our hospital were enrolled in this study. RTE and laboratory tests of liver function, blood routine and blood clotting were performed. Pathological evidence was obtained after liver biopsy. The accuracy of RTE scores and laboratory parameters in diagnosing liver fibrosis was compared. Results: Of the 90 patients, 21 were in stage S0, 31 in stage S1, 31 in stage S2, 20 in stage S3, and 7 in stage S4. The RTE score was positively correlated with the degree of liver fibrosis (r = 0.79, P <0.05). Similarly, aspartate aminotransferase / platelet ratio index (APRI) was also positively correlated with the degree of liver fibrosis (r = 0.57, P <0.05). The RTE score was only correlated with APRI (r = 0.667, P = 0.000). The sensitivity, specificity and accuracy of RTE were 94.31%, 78.65%, 85.22%, 76.63%, 94.58%, respectively, which were higher than those of APRI. Conclusion: Real-time tissue elastography has extensive clinical value and prospect in the diagnosis of liver fibrosis.