Fibroscan测定与超声影像学检查在诊断慢性乙肝相关肝纤维化中的价值

山东大学学报(医学版) ›› 2012, Vol. 50 ›› Issue (10): 115-.

Fibroscan测定与超声影像学检查在诊断慢性乙肝相关肝纤维化中的价值

李建志1，李洁1，熊春梅1，张梅芳1，郑雪2，张灵云2，张国全2，孙爱华1，单容1

1.济南市传染病医院超声诊断科，济南 250021；
2.山东大学附属省立医院超声诊断科，济南 250021

收稿日期:2012-06-06 出版日期:2012-10-10 发布日期:2012-10-10
通讯作者: 单容(1973- )，女，硕士，主治医师，主要从事肝病超声诊断方面研究。 E-mail：shanrong@126.com
作者简介:李建志(1981- ),男，硕士研究生，主要从事肝病超声诊断方面研究

Clinical value of Fibroscan stiffness measurement and ultrasonography
in diagnosing chronic hepatitis B-related fibrosis

LI Jian-zhi1， LI Jie1, XIONG Chun-mei1, ZHANG Mei-fang2, ZHENG Xue2,
ZHANG Ling-yun2， ZHANG Guo-quan2, SUN Ai-hua1， SHAN Rong1

1. Department of Ultrasound, Jinan Infectious Disease Hospital, Jinan 250021， China；
2. Department of Ultrasound， Shandong Provincial Hospital Affiliated to Shandong University， Jinan 250021， China

Received:2012-06-06 Online:2012-10-10 Published:2012-10-10

摘要/Abstract

摘要：

目的探讨应用Fibroscan(FS)及超声影像学指标综合积分法诊断慢乙肝相关肝纤维化的应用价值。方法研究对象为114例经肝穿确诊为慢乙肝的病例，经FS测定其硬度(stiffness)值，同时进行肝脏超声影像学检查，根据指标综合积分法对超声图像各指标进行半定量化评分，应用受试者工作特征(ROC)曲线分析方法，以肝活检病理学结果为金标准对FS值及各指标评分进行分析。结果随着肝纤维化程度的提高，FS值及超声影像学评分均逐渐升高，且与病理学结果存在良好的相关性(r=0.81、0.75、0.73、0.76、0.76、0.80,所有P<0.001)；ROC曲线分析肝脏FS值、实质、被膜、边缘、静脉、总评分的曲线下面积分别为0.89、0.84、0.84、0.83、0.81、0.86。结论慢乙肝患者中肝脏FS值及超声影像评分与病理学分期间存在良好的相关性，FS诊断慢乙肝肝纤维化程度亦具有较高的敏感性和特异性。

关键词: Fibroscan；瞬时弹性成像；肝纤维化；超声检查；肝炎，乙型，慢性

Abstract:

Objective To investigate the clinical value of Fibroscan stiffness measurement (FS) and ultrasonography (USG) in diagnosing chronic hepatitis B-related fibrosis. Methods 114 chronic hepatitis B patients confirmed by the liver biopsy were detected through FS and USG. The USG parameters such as hepatic parenchyma, capsule, edge and vein were graded by the semi-quantitative score method. The liver biopsy pathology results were used as the golden standard to test the parameters of FS and USG through the receiver operating characteristic (ROC) curve. Results The parameters of FS and USG increased gradually with liver fibrosis exacerbation．And these parameters were well correlated with the pathological change on the liver fibrosis (r=0.81, 0.75, 0.73, 0.76, 0.76, and 0.80, P<0.001) . The ROC curve analysis showed that the areas under the curve for stiffness， the changes score of hepatic parenchyma, capsule, edge and vein and their total score were 0.89, 0.84, 0.84, 0.83, 0.81 and 0.86 respectively. Conclusion The parameters of FS and USG are well correlated with the liver fibrosis pathological change in chronic hepatitis B patients. FS has high sensitivity and specificity in diagnosing chronic hepatitis B-related fibrosis.

Key words: Fibroscan; Transient elastography; Liver fibrosis; Ultrasonography; Liver cirrhosis， hepatitis B， Chronic

中图分类号:

R445.1

李建志1，李洁1，熊春梅1，张梅芳1，郑雪2，张灵云2，张国全2，孙爱华1，单容1 . Fibroscan测定与超声影像学检查在诊断慢性乙肝相关肝纤维化中的价值[J]. 山东大学学报(医学版), 2012, 50(10): 115-.

LI Jian-zhi1， LI Jie1, XIONG Chun-mei1, ZHANG Mei-fang2, ZHENG Xue2, ZHANG Ling-yun2,ZHANG Guo-quan2, SUN Ai-hua1， SHAN Rong1. Clinical value of Fibroscan stiffness measurement and ultrasonography
in diagnosing chronic hepatitis B-related fibrosis[J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2012, 50(10): 115-.

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