摘要
目的探讨常规超声与剪切波弹性成像(SWE)技术对乙型肝炎患者肝纤维化及分期的诊断价值。方法选取2021年7月至2023年8月于医院就诊的75例乙型肝炎患者,所有患者均接受常规超声检查、SWE检查及肝穿刺活检术。以肝穿刺活检结果为金标准,比较常规超声与SWE检查结果与肝穿刺活检结果的一致性及诊断效能。根据肝穿刺活检结果将肝纤维化患者分为4期,比较不同肝纤维化分期患者的SWE弹性模量结果,采用受试者工作特征(ROC)曲线分析弹性模量对不同肝纤维化分期患者的预测价值。结果75例乙型肝炎患者经肝穿刺活检术检查显示,肝纤维化64例、无肝纤维化11例。常规超声检查结果与肝穿刺活检结果的一致性较差(Kappa=0.244);SWE检查结果与肝穿刺活检结果的一致性较好(Kappa=0.901);SWE检查诊断乙型肝炎肝纤维化的灵敏度、特异度、准确度、阳性预测值、阴性预测值均高于常规超声检查,差异有统计学意义(P<0.05);经肝穿刺活检确诊的64例肝纤维化中,F1期20例、F2期30例、F3期6例、F4期8例,弹性模量分别为(5.34±1.12)kPa、(7.16±1.57)kPa、(7.60±0.52)kPa、(10.18±2.13)kPa,F2、F3、F4期患者的SWE弹性模量均高于F1期(P<0.05);ROC曲线分析结果显示,弹性模量对F4期肝纤维化的预测价值最高(曲线下面积最大),其次为F3、F2、F1期,弹性模量对F1~F4期肝纤维化患者的预测价值较高。结论SWE检查结果与金标准的检查结果一致性较高,其诊断效能高于常规超声检查,SWE弹性模量对乙型肝炎患者肝纤维化分期具有较高的诊断价值。
Objective To investigate the diagnostic value of conventional ultrasound and shear wave elastography(SWE)technology on liver fibrosis and staging in patients with hepatitis B.Methods 75 patients with hepatitis B attending the hospital from July 2021 to August 2023 were selected,all of whom underwent conventional ultrasonography,SWE examination and hepatic puncture biopsy.The concordance and diagnostic efficacy of conventional ultrasound and SWE findings with those of hepatic puncture biopsy were compared using the results of hepatic puncture biopsy as the gold standard.Patients with liver fibrosis were classified into 4 stages based on the results of hepatic puncture biopsy,and the results of SWE elastic modulus in patients with different liver fibrosis stages were compared,and the predictive value of elastic modulus in patients with different liver fibrosis stages was analysed by using receiver operating characteristic(ROC)curves.Results Examination of 75 patients with hepatitis B by liver puncture biopsy showed 64 cases of liver fibrosis and 11 cases without liver fibrosis,the agreement between the results of conventional ultrasonography and the results of hepatic puncture biopsy was poorly poor(Kappa=0.244);the results of SWE examination were in good agreement with those of liver puncture biopsy(Kappa=0.901);the sensitivity,specificity,accuracy,positive predictive value,and negative predictive value of SWE examination were higher than those of conventional ultrasonography,and the difference was statistically significant(P<0.05);75 patients with hepatitis B were diagnosed with hepatic fibrosis by liver puncture biopsy in 64 patients,of which 20 patients were in stage F1,30 patients were in stage F2,6 patients were in stage F3,and 8 patients were in stage F4,with elasticity modulus of(5.34±1.12)kPa,(7.16±1.57)kPa,(7.60±0.52)kPa,and(10.18±2.13)kPa,and the SWE elasticity modulus of patients in stage F2,F3 and F4 stage patients had higher SWE elastic modulus than F1 stage(P<0.05);the results of ROC curve analysis showed that elastic modulus had the highest predictive value for stage F4 liver fibrosis(largest area under the curve),followed by stages F3,F2 and F1,elastic modulus had a high predictive value for patients with liver fibrosis in stages F1 to F4.Conclusion The SWE results were in high agreement with those of the gold standard,and their diagnostic efficacy was higher than that of conventional ultrasonography,and the SWE elastic modulus results had a high diagnostic value for the staging of liver fibrosis in patients with hepatitis B.
作者
翁艳梅
陈辉
Weng Yanmei;Chen Hui(Putian First Hospital,Putian Fujian 351100,China)
出处
《医疗装备》
2025年第16期13-16,20,共5页
Medical Equipment
关键词
常规超声
剪切波弹性成像
乙型肝炎
肝纤维化
Conventional ultrasound
Shear wave elastography
Hepatitis B
Liver fibrosis
