摘要
目的:探讨声脉冲辐射力弹性成像技术(ARFI)在胆道闭锁(BA)及婴儿肝炎综合征(IHS)黄疸鉴别诊断中的价值,研究其弹性测值(SWV)与肝脏纤维化是否具有相关性。方法:应用西门子S3000彩色多普勒超声诊断仪对40例BA患儿、35例IHS患儿及25例正常婴儿进行二维超声检查,应用其ARFI技术对三组受检婴儿进行肝脏SWV并组间比较,经肝穿活检或手术病理证实的肝脏进行肝纤维化病理分期即F0~F4期,将不同肝纤维化分期的SWV组间比较,并与肝组织纤维化病理分期进行相关性分析。结果:BA黄疸组肝脏SWV值为(1.98±0.31)m/s,IHS黄疸组肝脏SWV值为(1.13±0.21)m/s,正常组肝脏SWV值为(1.10±0.24)m/s,BA黄疸组与IHS组、正常组比较差异具有统计学意义(F=10.958,P<0.05)。IHS组与正常组相比,SWV水平差异无统计学意义(t=1.431,P=1.34)。不同程度肝纤维化F0,F1,F2,F3,F4组间的肝脏SWV测值比较差异具有统计学意义(H=14.307,P<0.05),SWV测值与不同病理分期的肝纤维化之间显著正相关(r=0.932,P<0.05),肝纤维化分级增高,SWV测值增大。结论:ARFI作为一种无侵袭性、定量评价肝纤维化程度的超声弹性技术,为鉴别诊断婴儿黄疸类型提供了依据,可以客观评价BA患儿的病情进展及预后情况。
Objective: To investigate the diagnostic value of acoustic radiation force impulse(ARFI) in biliary atresia(BA)and infantile hepatitis syndrome jaundice(IHS), and to study whether the elastic value measured was related to liver fibrosis.Methods: Forty infants with BA, 35 infants with IHS and 25 normal infants underwent two-dimensional ultrasound by Siemens Acuson S3000 color Doppler ultrasound. We used its ARFI technique to measure the liver elasticity of three groups of infants shear wave velocity(SWV) and compared between groups. The pathological stage(F0, F1, F2, F3 and F4) of liver fibrosis was confirmed by liver puncture biopsies or surgery and pathology. SWV of different hepatic fiber stages were com-pared. Correlation between SWV and pathological stages of liver tissue fibrosis was also analyzed. Results: The SWV value of liver in BA jaundice group was(1.98±0.31) m/s, that in IHS group was(1.13±0.21) m/s, and that in normal group was(1.10±0.24) m/s. There was significant difference among BA group, IHS group and normal group(F=10.958, P<0.05). There was no significant difference in SWV level between IHS group and normal group(t=1.431, P=1.34). There were significant differences in liver SWV among groups F0, F1, F2, F3, F4 varying degrees of hepatic fibrosis(H=14.307, P<0.05), there was a significant positive correlation between SWV measured values and liver fibrosis in different pathological stages(r=0.932, P<0.05), liver fibrosis grade increased and SWV measured values increased. Conclusion: ARFI, as a noninvasive and quantitative method for evaluating the degree of liver fibrosis, provides a basis for differential diagnosis of jaundice in infants and can objectively as-sess the disease progression and prognosis of infants with biliary atresia.
作者
于瑞娜
滑少华
贺晓
李燕
陈洋
YU Rui-na;HUA Shao-hua;HE Xiao;LI Yan;CHEN Yang(Department of Ultrasonography,First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)
出处
《中国临床医学影像杂志》
CAS
2020年第7期500-502,共3页
Journal of China Clinic Medical Imaging
基金
国家临床重点专科建设项目(项目编号2013[544])。
关键词
胆道闭锁
肝硬化
超声检查
多普勒
彩色
Biliary atresia
Liver cirrhosis
Ultrasonography
Doppler
color
