| 摘要: |
| 目的 探讨二维剪切波弹性成像(2D-SWE)与瞬时弹性成像（TE）对慢性乙型肝炎（CHB）患者肝纤维化分期诊断价值的比较。方法 选取我院临床确诊的148例CHB患者，分别行2D-SWE及TE检查，以超声引导下肝组织穿刺活检病理结果作为金标准，比较分析两种弹性成像评估肝纤维化分期的诊断效能。结果2D-SWE及TE的弹性均值与病理肝纤维化分期呈显著正相关（r =0.914、0.783）；不同病理分期的两种检查方法平均弹性值组间差异均有统计学意义（P ＜0.05），且均随肝纤维化分期的加重而增加；构建受试者工作特性曲线（ROC曲线）比较两者的诊断效能得出2D-SWE诊断显著性肝纤维化（S2～S4）的ROC曲线下面积(AUC)分别为0.973、0.976及0.972，TE诊断显著性肝纤维化的AUC分别为0.903、0.909及0.904，2D-SWE各期诊断效能均优于TE（S2:Z=3.062、S3：Z=3.379、S4：Z=2.539，P均＜0.05）。结论 2D-SWE与TE技术在无创诊断CHB肝纤维化程度方面具有相似的诊断价值，但2D-SWE技术优于TE，更具有临床应用价值。 |
| 关键词: 慢性乙型肝炎 肝纤维化 弹性成像技术 |
| DOI： |
| 投稿时间：2018-01-15修订日期：2018-01-25 |
| 基金项目:兰州大学第二医院硕导基金(SDKYJJ-21),项目名称：超声SWE联合肝脏穿刺活检术评估慢性乙肝患者肝纤维化的诊断效能 |
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| Comparative study of two-dimensional shear wave elastography and Fibroscan on diagnosing liver fibrosis in patients with chronic hepatitis B |
| WANG Jiabing,TONG Minghui |
| (Department of Functional examination in Children’s hospital,The Second Hospital AffiliatedBeginEttoEndETLanzhou University,;Department of Third Ultrasonography,The Second Hospital Affiliated to Lanzhou University) |
| Abstract: |
| Objective To compare the diagnostic value between two-dimensional shear wave elastography (2D-SWE) and transient elastography (TE) for the stage liver fibrosis in patients with chronic hepatitis B (CHB).Methods One hundred and forty-eight cases of CHB patients performed 2D-SWE and TE examinations. The pathological fibrosis stage by ultrasound guided liver biopsy was used as the reference standard to evaluate the diagnostic efficacy of two kinds of elastography. Results There are positive interrelationships between two kinds of elastography and liver fibrosis(r =0.914、0.783).There were significant differences between 2D-SWE and TE quantitative elasticity in different pathological fibrosis stage(P ＜0.05), and the value of elasticity increased with the stage of liver fibrosis. The receiver operating characteristic curve (ROC curve) was used to compare the diagnostic efficacy between 2D-SWE and TE. The areas under the ROC curve(AUC) of 2D-SWE diagnosis of liver fibrosis (S2～S4) were 0.972,0.973 and 0.976,The AUC of TE diagnosis of liver fibrosis were 0.903、0.909 and 0.904,and there were significant differences that 2D-SWE was superior than TE in each liver fibrosis（S2:Z =3.062，S3:Z =3.379，S4:Z =2.539，all P ＜0.05).Conclusion 2D-SWE and TE have similar diagnostic value in noninvasive diagnosis of liver fibrosis with CHB, but the 2D-SWE which has more clinical application value is superior to TE. |
| Key words: Chronic hepatitis B Liver fibrosis Elasticity imaging techniques |
