二维超声剪切波弹性成像对慢性乙型肝炎患者肝纤维化程度的评估价值

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Abstract Objective To explore the diagnostic value of two-dimensional ultrasound shear-wave elastography for liver fibrosis in patients with chronic hepatitis B.Methods A total of 66 patients with chronic hepatitis B treated in Ji'an Hospital of Shanghai Oriental Hospital from January to December 2021 were retrospectively selected as the research objects.All patients were diagnosed by pathological examination,and underwent conventional ultrasound imaging and two-dimensional ultrasound shear wave elastography.Liver biopsy was taken as the gold standard.The degree of liver fibrosis of patients was divided into F0,F1,F2,F3 and F4 stages according to the METAVIR score standard.The patients were divided into groups according to the pathological grade,with F0＋F1 as non-significant liver fibrosis (nonsignificant group) and F2＋F3＋F4 as significant liver fibrosis (significant group).The age,cell,body mass index (BMI),Young's modulus,aspartate aminotransferase (AST),glutamyltransferase (GGT),alanine aminotransferase (ALT) and other indicators were collected,and liver fibrosis-4 factor index (FIB-4) and aspartate aminotransferase/platelet ratio index(APRI) were calculated.Univariate and multivariate logistic analysis were used to analyze the relevant data of patients,and ROC curve was used to evaluate the diagnostic efficacy of Young's modulus,FIB-4 and APRI in the significant degree of liver fibrosis in patients.Results The results of needle biopsy showed that among the selected 66 pa tients with chronic hepatitis B,5 cases were F0 stage,19 cases were F1 stage,23 cases were F2 stage,12 cases were F3 stage,and 7 cases were F4 stage.Therefore,F0＋F1 stage had non-significant liver fibrosis (non-significant group of 24 cases) and significant liver fibrosis (significant group of 42 cases).Univariate analysis showed that there were no significant differences in gender,age,BMI,AST,GGT,ALT,alkaline phosphatase (ALP),albumin and total bilirubin(TBil) between the two groups (P＞0.05).There were significant differences in Young's modulus,serum liver fibrosis indexes (laminin [LN],hyaluronic acid [HA],collagen Ⅳ[Ⅳ-C],pro-collagen Ⅲ[PⅢP]),FIB-4 and APRI between the two groups (P＜0.05).Multivariate logistic analysis showed that Young's modulus,LN,HA,Ⅳ-C,PⅢP,FIB-4 and APRI were independent risk factors for liver fibrosis (P＜0.05).ROC results showed that the AUC of Young's modulus value was 0.864,the diagnostic sensitivity was 82.6% and the specificity was 84.5%,the AUC of FIB-4 was 0.789,the diagnostic sensitivity was 80.7% and the specificity was 72.4%,and the AUC of APRI was 0.857 and the diagnostic sensitivity was 81.5%.The specificity was 83.8%,the combined AUC of the three groups of indicators was 0.935,the diagnostic sensitivity was 92.8%,and the specificity was 93.2%.Conclusion Two-dimensional shear wave elastography can be used to detect the significance of liver fibrosis in patients with chronic hepatitis B in a non-invasive manner,and the diagnostic efficiency is good.

Key words： Ultrasonic two-dimensional shear-wave elastic imaging Chronic hepatitis B Diagnostic value Liver fibrosis

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	LIU Xiaowei QIN wenling CHEN Min CHEN Xuemei▲ GU Wen YANG Lihua

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LIU Xiaowei QIN wenling CHEN Min CHEN Xuemei▲ GU Wen YANG Lihua. Evaluation of the degree of liver fibrosis in patients with chronic hepatitis B by two-dimensional ultrasonic shear-wave elastography[J]. 中国当代医药, 2022, 29(28): 143-147.

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https://www.dangdaiyiyao.com/EN/ OR https://www.dangdaiyiyao.com/EN/Y2022/V29/I28/143

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