本文選題：實時剪切波彈性成像 + 肝纖維化　； 參考：《寧波大學(xué)》2017年碩士論文

【摘要】：目的探討實時剪切波彈性成像技術(shù)(real-time shear wave elastography,SWE)無創(chuàng)定量評價CHB患者隱匿進展性肝纖維化程度的臨床價值。方法選取來我院就診臨床確診為CHB患者827例,常規(guī)經(jīng)過血液學(xué)、SWE與肝穿刺活檢病理學(xué)檢查,血液學(xué)檢查ALT、AST低于檢測下限及影像學(xué)檢查正常為實驗組,ALT、AST和(或)影像學(xué)檢查異常為對照組,以病理結(jié)果為金標準,對肝臟彈性模量值與實驗組和對照組CHB患者肝纖維化程度的相關(guān)性進行分析。結(jié)果827例CHB患者中實驗組644例,對照組183例。CHB患者在不同肝纖維化分期組間性別比例無差別,而年齡、肝臟彈性模量值差別都具有統(tǒng)計學(xué)意義。肝臟彈性模量值與實驗組CHB患者肝纖維化程度呈正相關(guān),Spearman相關(guān)系數(shù)為0.665,P=0.000。SWE技術(shù)診斷實驗組CHB患者進展性肝纖維化程度S≥3期閾值為7.96Kpa,特異度80.2%,靈敏度為83.5%,曲線下面積為0.889;診斷對照組CHB患者進展性肝纖維化程度S≥3期閾值為8.59Kpa,特異度70%,靈敏度為75.9%,曲線下面積為0.856。兩位醫(yī)師用SWE檢測不同纖維化分期CHB患者的組間及組內(nèi)重復(fù)性良好,S0~S4各分期組間相關(guān)系數(shù)為0.901、0.917、0.945、0.979、0.891。結(jié)論1.SWE技術(shù)診斷ALT和AST低于檢測下限、影像學(xué)檢查正常的實驗組CHB患者肝纖維化程度≥S3期曲線下面積為0.889,表明SWE技術(shù)對ALT和AST低于檢測下限、影像學(xué)檢查正常CHB患者具有較高的診斷效能,且能為臨床提供準確的客觀依據(jù),可無創(chuàng)定量評價CHB患者隱匿進展性肝纖維化程度。2.肝功能轉(zhuǎn)氨酶指標AST、ALT會對SWE技術(shù)測量肝臟彈性模量值產(chǎn)生影響。
[Abstract]:Objective to evaluate the clinical value of real-time shear wave elastography (SWE) in noninvasive quantitative evaluation of occult progressive hepatic fibrosis in patients with CHB. Methods 827 patients with CHB were selected and examined by hematology and liver biopsy. Hematological examination of alt was lower than the lower detection limit and normal imaging examination was the control group with abnormal alt AST and / or imaging examination, and the pathological results were regarded as the gold standard. The relationship between the elastic modulus of liver and the degree of hepatic fibrosis in CHB patients was analyzed. Results there were 644 cases in the experimental group and 183 cases in the control group in 827 patients with CHB. There was no difference in sex ratio among the groups with different stages of hepatic fibrosis, but the difference of age and modulus of elasticity of liver was statistically significant. There was a positive correlation between liver modulus of elasticity and the degree of hepatic fibrosis in experimental group CHB patients. The correlation coefficient of Spearman correlation coefficient was 0.665P ~ (0.000.SWE) for the diagnosis of progressive hepatic fibrosis in CHB patients in experimental group. The threshold value of S 鈮，

本文編號：1914971