| 摘要: |
| 目的：探讨声辐射力脉冲成像技术(acoustic radiation force impulse imaging,ARFI)在无创定量评估2型糖尿病(type 2 diabetes mellitus ,T2DM)患者非酒精性脂肪肝(non-alcoholic fatty liver disease ,NAFLD)程度的临床应用价值。方法：对201例2型糖尿病患者进行常规肝脏彩超检查,分成NAFLD组(95例)及正常肝脏组(106例)。收集患者的相关资料及血液生化指标,根据肝功能相关指标将NAFLD组分为肝功能正常组(39例)和肝功能不全组(56例),运用ARFI技术对所有患者行肝脏弹性的测定,并进行统计学分析。结果：NAFLD组ARFI值较正常肝脏组减低(P<0.01)。NAFLD组中肝功能不全组较正常组的ARFI值升高(P=0.022)。NAFLD与正常肝脏ARFI值的受试者工作特征(ROC)曲线线下面积0.745,临界值为1.06m/s,95%的可信区间为0.616~0.814,敏感性88.7%,特异性45.7%。NAFLD组的患者中ARFI指数与甘油三酯、BMI指数相关。结论：ARFI技术可定量诊断2型糖尿病患者的非酒精性脂肪肝,有助于评估肝脏脂肪变性的程度,有着良好的临床应用价值。 |
| 关键词: 2型糖尿病，非酒精性脂肪肝，超声，ARFI，血生化指标 |
| DOI： |
| 投稿时间：2016-03-14修订日期：2016-10-12 |
| 基金项目:南京市医药卫生科研项目《运用声脉冲辐射力成像技术(ARFI)测定的肝脏剪切波速度与脂肪肝和代谢综合征相关性研究》基金资助(项目编号：YKK14077) |
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| Non-invasive assessment of non-alcoholic fatty liver disease (NAFLD) in type 2 diabetes mellitus (T2DM) patients using the Acoustic Radiation Force Impulse (ARFI) Imaging |
| gongli,wumin |
| () |
| Abstract: |
| Purpose: To evaluate the ARFI technique in non-invasive diagnosis and quantification of NAFLD in MS patients. Methods: A total of 201 type 2 diabetes mellitus (T2DM). patients undergoing normal liver Doppler ultrasound examination were enrolled in the study (95 with NAFLD and 106 without NAFLD). 56 patients (out of 95) in the NAFLD group were diagnosed with hepatic insufficiency (NAFLD-HI) and the remaining 39 patients in the NAFLD group had normal liver functions (NAFLD-normal), according to the blood biochemical parameters, physical exam and patient history. The liver elasticity of all MS patients was measured using the ARFI technique. The ARFI parameters for the NAFLD group and non-NAFLD group, as well as the NAFLD-HI group and the NAFLD-normal group were analyzed and compared.Results: The ARFI parameters for the NAFLD group is significantly lower than the non-NAFLD group among MS patients (p<0.01). The ARFI parameters for patients in the NAFLD-HI group are significantly higher than patients in the NAFLD-normal group (p=0.022). The area under the receiver-operator curve (ROC) for classifying NAFLD and non-NAFLD groups using ARFI parameter values is 0.745 (95% confidence interval 0.616~0.814). The sensitivity and specificity at the optimal cut-off point on ROC (1.06 m/s) are 88.7% and 45.7% respectively. The ARFI values were found to be correlated with triglyceride level and body mass index for the NAFLD patient group.Conclusions: The ARFI technique is capable of non-invasive assessing and detecting the NAFLD in T2DM patients in clinic practice. |
| Key words: type 2 diabetes mellitus (T2DM),non-alcoholic fatty liver disease, ultrasound, Acoustic Radiation Force Impulse Imaging, blood biochemical parameters |
