尹珊珊,陈敏华,戴莹,武金玉,严昆.超声造影定量诊断肝纤维化[J].中国医学影像技术,2012,28(12):2206~2210
超声造影定量诊断肝纤维化
Quantitative diagnostic value of contrast enhanced ultrasound of liver fibrosis
投稿时间:2012-04-25  修订日期:2012-07-05
DOI:
中文关键词:  超声检查  造影剂  肝硬化
英文关键词:Ultrasonography  Contrast media  Liver cirrhosis
基金项目:北京大学肿瘤医院院内基金(04-17)。
作者单位E-mail
尹珊珊 北京大学肿瘤医院暨北京市肿瘤防治研究所超声科, 恶性肿瘤发病机制及转化研究教育部重点实验室, 北京 100142  
陈敏华 北京大学肿瘤医院暨北京市肿瘤防治研究所超声科, 恶性肿瘤发病机制及转化研究教育部重点实验室, 北京 100142 minhuachen@bjcancer.org 
戴莹 北京大学肿瘤医院暨北京市肿瘤防治研究所超声科, 恶性肿瘤发病机制及转化研究教育部重点实验室, 北京 100142  
武金玉 北京大学肿瘤医院暨北京市肿瘤防治研究所超声科, 恶性肿瘤发病机制及转化研究教育部重点实验室, 北京 100142  
严昆 北京大学肿瘤医院暨北京市肿瘤防治研究所超声科, 恶性肿瘤发病机制及转化研究教育部重点实验室, 北京 100142  
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中文摘要:
      目的 探讨CEUS定量诊断肝纤维化的可行性及意义。 方法 对肝纤维化组118例及对照组27例患者行CEUS检查,应用时间-强度曲线记录造影剂到达肝动脉、肝静脉、门静脉及肝实质的时间及达峰值时间,分析不同分期肝纤维化的灌注规律。 结果 在不同分期肝纤维化患者中,造影剂到达肝动脉时间、达峰值时间及门静脉达峰值时间的差异无统计学意义(P均>0.05);S1~S4期患者门静脉到达时间均长于S0(P均<0.05);S3及S4期患者肝静脉到达时间显著短于S0期(P均<0.05);S4期患者肝实质达峰值时间显著早于S0期(P<0.05)。应用ROC曲线,以肝静脉到达时间≤23 s为界值,CEUS诊断肝硬化(S4)的敏感度为79.0%,特异度为85.2%;以肝实质达峰值时间≤27 s为界值,诊断肝硬化的敏感度为55.6%,特异度为100%。 结论 CEUS技术有助于定量诊断肝纤维化,并有望对肝硬化前期做出诊断。
英文摘要:
      Objective To explore the quantitative diagnostic value of CEUS of liver fibrosis. Methods Totally 145 patients underwent CEUS, including 118 patients with hepatitis history ( liver fibrosis group) and 27 patients without chronic hepatitis history and clinical signs (control group). Liver samples were achieved with biopsy or operation. The arrival time and peak time of hepatic artery, hepatic vein, portal vein and liver parenchyma were observed by using time intensity curves, and the relationship of fibrosis stages and the perfusion times among each stage was investigated. Results The arrival time and peak time of hepatic artery and the peak time of portal vein were not significantly different in different fibrosis stage. The arrival time of portal vein in S1-S4 was longer than S0 (all P<0.05). The arrival time of hepatic vein in S3 and S4 were significantly shorter than S0 (both P<0.05). The peak enhancement time of liver parenchyma in S4 was earlier than S0 (P<0.05). ROC analysis showed when the arrival time of hepatic vein ≤23 s, the sensitivity and specificity of CEUS in diagnosis of liver cirrhosis (S4) was 79.0% and 85.2%, for the peak time of liver parenchyma ≤27 s, the value of sensitivity and specificity was 55.6% and 100%, respectively. Conclusion CEUS has potential as non-invasive diagnostic modality for cirrhosis, and may be useful to diagnosis of pre-cirrhosis.
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