| 李琼,刘闪闪,徐丽红,杜婷婷,童谨,张俐娜,刘帆,杨欣,李军.肝、脾硬度预测食管胃底静脉曲张及出血风险[J].中国医学影像技术,2018,34(4):563~567 |
| 肝、脾硬度预测食管胃底静脉曲张及出血风险 |
| Liver and spleen stiffness in diagnosing esophageal varices and predicting high risk of esophageal and gastric varices bleeding |
| 投稿时间：2018-01-02 修订日期：2018-04-02 |
| DOI：10.13929/j.1003-3289.201703007 |
| 中文关键词: 超声检查 肝硬化 食管和胃静脉曲张 |
| 英文关键词:Ultrasonography Liver cirrhosis Esophageal and gastric varices |
| 基金项目:国家自然科学基金（81360076）。 |
|
| 摘要点击次数: 1802 |
| 全文下载次数: 965 |
| 中文摘要: |
| 目的 探讨肝脏、脾脏硬度诊断乙型肝炎（简称乙肝）肝硬化患者食管胃底静脉曲张（EGV）和评估静脉曲张破裂出血风险的价值。方法 对71例确诊为乙肝肝硬化患者行胃镜、声脉冲辐射力弹性成像（ARFI）等相关检查，对EGV程度分级并测定患者的肝、脾脏剪切波速度（SWV），绘制ROC曲线，比较其诊断EGV和评估静脉破裂出血高风险的价值。结果 有EGV乙肝肝硬化患者的肝脏SWV（LSWV）和脾脏SWV（SSWV）均高于无EGV乙肝肝硬化患者（P均<0.001）；以胃镜结果为金标准，LSWV、SSWV诊断EGV的ROC曲线下面积（AUC）分别为0.877和0.910（P均<0.001），最佳界值点分别为2.01 m/s和2.84 m/s，敏感度为93.5%和76.1%，特异度为76.0%和92.0%；其预测静脉曲张破裂出血高风险的AUC分别为0.882和0.914（P均<0.001），最佳界值点分别是2.27 m/s和2.94 m/s，敏感度为77.1%和85.7%，特异度为83.3%和91.7%。结论 肝脏、脾脏硬度有助于诊断乙肝肝硬化患者EGV以及预测静脉曲张破裂出血风险。 |
| 英文摘要: |
| Objective To explore the value of liver and spleen stiffness in diagnosing esophageal and gastric varices (EGV) and predicting high risk of EGV bleeding in patients with hepatitis B virus (HBV)-related liver cirrhosis. Methods Totally 71 patients with HBV-related liver cirrhosis who had undergone endoscopy were prospectively recruited. Then acoustic radiation force imaging (ARFI) was performed. The severity of EGV was graded and ROCs were drawn on the liver shear wave velocity (LSWV) and spleen shear wave velocity (SSWV) to detect the value of liver and spleen stiffness in diagnosing EGV and predicting the high risk of EGV bleeding. Results There were significant differences of LSWV and SSWV between patients with EGV and without EGV (all P<0.001). Taking endoscopy results as golden standards, the areas under ROC curve of LSWV and SSWV were 0.877 and 0.910 (both P<0.001) in diagnosing esophageal varices, and the optimal cut-off values were 2.01 m/s and 2.84 m/s (sensitivity 93.5% and 76.1%, specificity 76.0% and 92.0%), respectively. Areas under ROC curve of LSWV and SSWV in predicting the high risk of EGV bleeding were 0.882 and 0.914 (both P<0.001), and the optimal cut-off values were 2.27 m/s and 2.94 m/s (sensitivity 77.1% and 85.7%, specificity 83.3% and 91.7%), respectively. Conclusion Liver and spleen stiffness are useful in diagnosing EGV and predicting the high risk of EGV bleeding in patients with HBV-related liver cirrhosis. |
| 查看全文 查看/发表评论 下载PDF阅读器 |
|
|
|
