| 摘要: |
| 目的 探讨声脉冲辐射力成像技术(Acoustic Radiation Force Impulse,ARFI)与肝纤维化的关系,以降低肝癌患者术后并发症的可能。 方法 纳入我院150例行肝癌手术切除的患者,对其手术前后的临床资料进行分析。依据肝纤维化分期标准,将肝纤维化S0、S1、S2、S3、S4分别对应的剪切波值进行单因素方差分析,再分析剪切波值与肝纤维化的相关性；进一步利用剪切波值构建ROC曲线分析肝纤维化的鉴别能力；最后通过剪切波值与病理结果检验肝癌术后并发症的敏感度、特异度对比,反应ARFI的应用的价值。 结果 S0、S1、S2、S3、S4分别对应的剪切波值显著升高,差异有统计学意义 (F=54.678,P﹤0.05)。剪切波值与肝纤维化程度呈正相关关系(r=0.76,P=0.000)； ROC曲线得到ARFI鉴别判断肝纤维化的AUC为0.885,最佳临界值为1.315,敏感度94.6%以及特异度为64.5%。进一步的分析发现,ARFI判断术后并发症敏感度和特异度与病理结果近似(ARFI：敏感度94.4%、特异度92.7%；病理：敏感度98.1%、特异度94.8%)。结论 ARFI有助于提高术前判断肝癌患者肝纤维化准确度,为今后肝癌患者减少术后并发症的发生提供参考依据。 |
| 关键词: ARFI 剪切波值 肝癌 肝纤维化 术后病理 |
| DOI： |
| 投稿时间：2016-12-06修订日期：2016-12-06 |
| 基金项目:上海市浦东新区卫生局卫生科技项目（PW2012A-24） |
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| Correlation#$NBSanalysis of Acoustic Radiation Force Impulse and the postoperative complications of liver cancer |
| LIU Xiao-Yan |
| (Department of ultrasound,Erdos Central Hospital,Inner Mongolia,;Department of ultrasound,tongji university affiliated Shanghai east hospital) |
| Abstract: |
| Objective To explore the relationship between Acoustic Radiation Force Impulse (ARFI) and Hepatic Fibrosis in order to reduce patients" postoperative complications after liver cancer surgery.Methods According to the liver fibrosis stage standard, one hundred and fifty patients with liver carcinoma were analyzed about clinical data and the extent of liver fibrosis stage was quantitatively analyzed by ARFI. Patients were divided into fibrosis S0, S1, S2, S3, S4 five groups. One-way ANOVA were implemented to analyze the SWVs (Shear Wave Value) in these groups. Then the relationship between ARFI and Hepatic Fibrosis was analyzed. Furthermore, ROC curve based on SWV was performed to identify the diagnosis of hepatic fibrosis. In the end, the postoperative complications was evaluated through SWVS and pathological reports and the sensitivity and specificity were compared to imply the application of ARFI. Results The SWVs in the S0, S1, S2, S3 and S4 groups were significantly increasing. The differences was statistically significant (F=54.678,P<0.05). Correlation analysis has shown a positive correlation between SWV and liver fibrosis stage (r=0.76,P=0.000). The ROC of the liver fibrosis diagnosis by ARFI showed that the AUC was 0.885, the best critical value was 1.315, and the sensitivity was 94.6% but specificity was 64.5%. Further analysis found that the prediction of postoperative complications by ARFI and pathological reports were similar (ARFI: Sensitivity 94.4%, Specificity 92.7%; pathological reports: Sensitivity 98.1%, Specificity 94.8%). Conclusion ARFI is helpful to improve the prediction of liver fibrosis in liver carcinoma patients. It provides impotent information for reduction of postoperative complications. |
| Key words: ARFI Shear Wave Velocity(SWV) liver carcinoma hepatic fibrosis pathological reports after operation |
