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目的通过对乙肝患者肝脏声学结构定量(ASQ)分析与病理及Fibroscan结果对比,初步探讨ASQ技术对乙肝肝纤维化分期的诊断价值。方法收集在我院确诊为慢性乙型肝炎患者66例,进行ASQ分析和Fibroscan检查,继之行肝脏穿刺活检。结果随着肝纤维化程度的增加,ASQ定性分析彩色编码图表现为黄绿色区减少,红色区域增加,且不规则;ASQ定量分析图表现为红色曲线峰值变小,蓝色曲线峰值变大,曲线下面积增大。ASQ定量参数BR-Ratio值在各组之间均有显著性差异(P<0.05)且与肝纤维化分期有较好正相关(r=0.772,P<0.05),当S≥1、S≥2、S≥3、S≥4时BR-Ratio值的曲线下面积(AUC)分别为0.832、0.913、0.962、0.974;BR-Ratio值区分S≥1、S≥2、S≥3、S≥4的截断值分别为0.33、0.37、0.49、0.55。对ASQ及Fibroscan的AUC进行比较,P均>0.05。结论 ASQ技术对肝纤维化程度的诊断价值与Fibroscan相近,在肝纤维化定量诊断中具有潜在的临床应用前景。
Objective To investigate the diagnostic value of ASQ in the staging of hepatitis B liver fibrosis by comparing the quantitative analysis of acoustic structure (ASQ) with pathology and Fibroscan results of hepatitis B patients. Methods Sixty-six patients diagnosed as chronic hepatitis B in our hospital were collected for ASQ analysis and Fibroscan examination, followed by liver biopsy. Results As the degree of liver fibrosis increased, the color-coded images of ASQ qualitative analysis showed yellow-green area decreased and red area increased and irregular. ASQ quantitative analysis showed that the peak of red curve became smaller and the peak of blue curve became larger, Area under the curve increases. There was a significant positive correlation between the BR-Ratio value of ASQ and each group (P <0.05) and positive correlation with staging of liver fibrosis (r = 0.772, P <0.05) 2, the area under the curve (AUC) of BR-Ratio values of S≥3 and S≥4 were 0.832, 0.913, 0.962 and 0.974 respectively; the BR-Ratio values were S≥1, S≥2, S≥3, S≥ 4 cutoff values were 0.33,0.37,0.49,0.55. AUC of ASQ and Fibroscan were compared, P> 0.05. Conclusion The diagnostic value of ASQ for Fibroscan is similar to that of Fibroscan. It has potential clinical application in the quantitative diagnosis of hepatic fibrosis.