摘要
目的探讨声脉冲辐射力成像(ARFI)技术测得的肝脏横向剪切波速度(Vs)和天门冬氨酸氨基转移酶与血小板比值指数(APRI)在诊断肝硬化Child-Pugh分级中的价值。方法回顾分析2014年7月至2015年7月在上海市大华医院就诊的肝硬化患者150例及正常者50例应用ARFI技术测得的Vs值,并计算APRI指数。将肝硬化患者作为观察组并按照Child-Pugh分级标准分为A、B、C 3级,各50例,正常者50例作为对照组。采用独立样本t检验比较观察组与对照组间测量指标的差异;将观察组Vs值与APRI指数进行Pearson直线相关分析及受试者工作特征(ROC)曲线分析。结果观察组Vs值与APRI指数均高于对照组,差异有统计学意义(P<0.01),且观察组不同Child-Pugh分级患者Vs值与APRI指数比较差异均有统计学意义(P<0.01);观察组Vs值与APRI指数均呈正相关(r=0.856,P<0.01);Vs值与APRI指数在Child A级中的ROC曲线下面积分别为0.86、0.75;在Child B级中的ROC曲线下面积分别为0.92、0.83;在Child C级中的ROC曲线下面积分别为0.99、0.90。结论 Vs值较客观的反映肝脏弹性硬度的指标,与APRI指数比较具有显著的相关性,二者联合可更好的评估肝硬化程度。
Objective To investigate the value of wave force impulse （Vs） radiation velocity imaging （ARFI） and ratio in- dex acoustic （APRI） shear Child-Pugh （AST/PLT） in the diagnosis of liver cirrhosis. Methods Retrospective analysis was made on the 150 patients with cirrhosis who were treated in Dahua Hospital of Xuhui District, Shanghai from July 2014 to July 2015, and the Vs values in 50 healthy subjects were measured by ARFI and the APRI indexes were calculated. The patients with cirrhosis were divided into the observation group （ in 3 grades, A, B and C） in accordance with the Child-Pugh grades, each consisting of 50 patients and an- other 50 normal subjects were used as the control group. T test was used to compare the differences in the detected data between the ob- servation group and the control group. The Vs values and APRI indexes of the observation group were used to analyze the linear correla- tion between the Pearson and the receiver operator characteristic （ROC）. Results The Vs values and APRI indexes of the observation group were all higher than those of the control group, with statistical significance （P 〈 0.01 ）. The Vs values of different Child-Pugh grades in the observation group were significantly correlated with the APRI indexes （P 〈 0.01 ）. Positive correlation could be seen in the Vs values and APRI indexes of the observation group（ r = 0. 856, P 〈 0.01 ）. The Vs values and APRI indexes below the ROC curve area in Child grade A were respectively 0.86 and 0.75, while the Vs values and APRI indexes below the ROC curve area in Child gradeB were respectively 0.92 and 0.83, and those in Child grade C were respectively 0.99 and 0. 90. Conclusion The Vs values could re- fleet more objectively the index of liver elastic stiffness, and significant correlation could be noted, when it was compared with the APRI index, and the combination of the two could more positively evaluate the extent of liver cirrhosis.
出处
《海军医学杂志》
2016年第1期43-46,共4页
Journal of Navy Medicine
基金
上海市徐汇区科委课题(SHXH201217)
关键词
肝脏
声脉冲辐射成像
横向剪切波速度
肝硬化
Liver
Acoustic radiation force impulse imaging
Shear wave velocity
Cirrhosis
