| 摘要: |
| 【【摘要】
目的：分析慢性乙型肝炎所致不同程度肝纤维化的高频超声声像图特征，探索高频声像图特征积分对慢性乙型肝炎肝纤维化的诊断价值。
方法：回顾2015年1月至2017年10月于华西医院就诊的慢性乙型肝炎患者高频超声检查资料，根据声像图特征肝脏包膜及实质回声不同表现进行赋值，并对同一研究对象肝脏包膜及肝脏实质回声进行分值叠加作为高频超声综合积分。以肝脏纤维化病理分期作为金标准，按照Scheuer国际通用肝纤维分期评估方案进行。通过有序回归分析评估高频超声声像图积分赋值的合理性。采用Spearman相关系数评价肝脏高频声像图特征积分与肝脏病理纤维化分期之间的相关关系。通过受试者操作特征（Receiver operating characteristic，ROC）曲线评估肝脏高频超声对慢性乙型肝炎纤维化的诊断价值。
结果：本研究最终纳入1795例慢性乙型肝炎患者，肝脏高频声像图特征诊断肝纤维化的曲线下面积较大，高频声像图赋值叠加作为综合积分对各期肝纤维化诊断效能均为最高，尤其是诊断重度肝纤维化及肝硬化。高频声像图叠加综合积分4分及以上肝硬化可能性大，综合积分3分重度肝纤维化可能性大，综合积分2分及以下肝脏纤维化程度较轻。
结论：肝脏高频声像图特征积分诊断慢性乙肝肝纤维化具有可行性，叠加综合积分诊断效能高于单一声像图特征指标。高频超声成像可无创且较准确诊断慢性乙肝肝纤维化，值得进一步研究和临床应用推广。
】 |
| 关键词: 高频超声成像 乙肝 肝纤维化 肝硬化 |
| DOI： |
| 投稿时间：2019-02-20修订日期：2019-05-31 |
| 基金项目: |
|
| The Value of high-frequency ultrasonography scoring system in assessing liver fibrosis of hepatitis B |
| zhongyue |
| (Department of Ultrasound, first people''s Hospital, Neijiang City, Sichuan Province) |
| Abstract: |
| Objective To assess the value of high-frequency ultrasonography scoring system in assessing liver fibrosis of hepatitis B
Method This was a retrospective study from January 2015 to October 2017. Patients with hepatitis B were performed by ultrasound with a 9-3MHz linear transducer (iU22,Philips Healthcare, Andover, MA) for evaluation of liver stiffness prior to surgery, and the features of liver capsule and liver parenchyma were scored and the scored values were comparatively analyzed with the staging of the pathological liver fibrosis. Pathologic findings of liver fibrosis were classified as S0, S1, S2, S3, and S4, according to Scheuer’s scoring system. Spearman correlation test was used to determine the relationship between ultrasound scoring system and fibrosis. The area under receiver operating curve (AUROC) was used to assess the diagnostic performance of ultrasound scoring system. The relationship between high-frequency ultrasonography scoring system and liver fibrosis stage were investigated.
Results A total of 1795 CHB patients were included in this study. The correlation coefficient between high-frequency ultrasonography integrated score and fibrosis stage was 0.745 (P<0.05). The AUROC of high-frequency ultrasonography integrated score in assessing significant liver fibrosis (≥S3) and liver cirrhosis(S4) were 0.920(0.906-0.932), and 0.881(0.866-0.896), respectively, which were better than the scores of liver capsule and liver parenchyma(P＜0.05). The score to detect liver fibrosis stage S3 and S4 were 3 and 4 as high-frequency ultrasonography integrated score respectively.
Conclusion High-frequency Ultrasonography is a reliable method for assessing liver fibrosis in patients with CHB, especially in significant fibrosis. |
| Key words: High-frequency Ultrasonography Chronic hepatitis B Liver fibrosis |
