| 叶桂林,黄河,凌文武,邱婷婷,卢强,林玲,罗燕.实时二维剪切波弹性成像诊断自身免疫性肝病患者肝纤维化程度[J].中国医学影像技术,2021,37(3):401~405 |
| 实时二维剪切波弹性成像诊断自身免疫性肝病患者肝纤维化程度 |
| Real-time two-dimensional shear wave elastography for diagnosis of liver fibrosis in patients with autoimmune liver diseases |
| 投稿时间：2020-03-03 修订日期：2020-12-24 |
| DOI：10.13929/j.issn.1003-3289.2021.03.021 |
| 中文关键词: 肝疾病 自身免疫疾病 肝纤维化 诊断 弹性成像技术 |
| 英文关键词:liver diseases autoimmune diseases hepatic fibrosis diagnosis elasticity imaging techniques |
| 基金项目:国家自然科学基金（81671702）、四川大学华西医院专职博士后研发基金（2019HXBH014）。 |
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| 中文摘要: |
| 目的 评估实时二维剪切波弹性成像（2D-SWE）诊断自身免疫性肝病（AILD）患者肝纤维化程度的效能。方法 回顾性分析102例AILD的临床2D-SWE资料。采用Kendall's tau-b检验分析肝硬度测值（LSM）与肝纤维化分期、炎症分级的相关性；绘制受试者工作特征（ROC）曲线，以肝活体组织检查（LB）作为金标准，评估2D-SWE诊断各期肝纤维化的效能；以Logistic回归分析观察影响其诊断准确率的因素。结果 LSM与纤维化分期呈正相关（r=0.58，P<0.01），与炎症分级无显著相关（r=0.29，P<0.01）。2D-SWE诊断≥ F2期、≥ F3期和F4期肝纤维化的ROC曲线下面积分别为0.93、0.86及0.86；截断值为8.10 kPa、10.20 kPa及13.50 kPa时，敏感度分别为89.16%、80.00%及88.46%，特异度分别为84.21%、76.60%及82.89%。对F4期肝纤维化，白蛋白是影响2D-SWE诊断准确率的独立影响因素（OR=1.10，P=0.01）。结论 2D-SWE可评估AILD肝纤维化程度，对≥ F2期诊断效能更优，且干扰因素较少。 |
| 英文摘要: |
| Objective To assess the performances of real-time two-dimensional shear wave elastography (2D-SWE) on the degree of hepatic fibrosis in patients with autoimmune liver disease (AILD). Methods The clinical and 2D-SWE data of 102 patients with AILD were retrospectively analyzed. Taken liver biopsy (LB) as the gold standards, Kendall's tau-b test was used to explore the correlations of liver stiffness measurement (LSM) and fibrosis stage and inflammatory activity score. Receiver operating characteristic (ROC) curves were constructed to assess the efficacy of 2D-SWE in diagnosing liver fibrosis in each stage, and Logistic regression analysis was carried out to analyze the impact factors of the diagnostic accuracy. Results LSM positively correlated with fibrosis stage (r=0.58, P<0.01),but not significantly correlated with inflammatory activity grade (r=0.29, P<0.01). The area under the ROC curve of 2D-SWE for diagnosing liver fibrosis ≥ F2 stage, ≥ F3 stage and F4 stage was 0.93, 0.86 and 0.86, respectively. Taken 8.10 kPa, 10.20 kPa and 13.50 kPa the cut-off values, the sensitivity was 89.16%, 80.00% and 88.46%, the specificity was 84.21%, 76.60% and 82.89%, respectively. For F4stage of liver fibrosis, albumin was the independent impact factor of the diagnostic accuracy of 2D-SWE (OR=1.10, P=0.01). Conclusion 2D-SWE could evaluate liver fibrosis stage in AILD patients, being more effective with fewer interfering factors for ≥ F2 stages liver fibrosis. |
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