本文關(guān)鍵詞： 肝硬化 聲觸診組織量化技術(shù) 剪切波速度 肝臟纖維化　出處：《吉林大學(xué)》2014年碩士論文　論文類型：學(xué)位論文

【摘要】：目的： 通過聲觸診組織量化（virtual touch tissue quantification, VTQ）技術(shù)研究早期肝硬化的組織硬度變化，探討早期肝硬化肝臟左、右葉的彈性指數(shù)變化是否一致。尋找最能反映早期肝硬化肝臟組織彈性的部位，提高超聲影像診斷對早期肝硬化的診斷水平，并為早期肝硬化的確診及臨床治療提供可靠的影像學(xué)依據(jù)，進(jìn)一步提高超聲檢查在彌漫性肝病特別是早期肝硬化中的應(yīng)用價(jià)值。 方法： 根據(jù)Scheuer標(biāo)準(zhǔn)，選擇2012年9月至2013年12月間就診于吉林大學(xué)第二醫(yī)院并均經(jīng)肝穿刺活檢肝纖維化S4期的51例早期肝硬化患者（男32名，女19名），平均年齡(46.41±1.42)歲。正常對照組50例（男29名，女21名），平均年齡(43.12±1.07)歲，入選標(biāo)準(zhǔn)為無肝、腎、心、腦疾病，肝、腎功能正常，肝炎病毒標(biāo)志物陰性。應(yīng)用ACUSON S2000彩色多普勒超聲診斷儀，利用聲觸診組織量化技術(shù)對兩組患者分別測量肝左、右葉的剪切波速度（VTQ）。數(shù)據(jù)分析：采用SPPS17.0統(tǒng)計(jì)分析軟件，計(jì)量資料以均數(shù)±標(biāo)準(zhǔn)差（x±S）表示。兩組肝臟左、右葉之間VTQ參考值分別采用配對樣本t檢驗(yàn)，比較差異有無統(tǒng)計(jì)學(xué)意義。兩組間計(jì)量資料采用獨(dú)立樣本t檢驗(yàn)，P0.05有統(tǒng)計(jì)學(xué)意義。 結(jié)果： 1.正常對照組肝臟左、右葉VTQ參考值分別為（1.22±0.066）m/s（、1.21±0.056）m/s，對比分析肝臟左、右葉VTQ值無統(tǒng)計(jì)學(xué)意義（p0.05） 2.早期肝硬化肝臟左葉組VTQ參考值為（2.79±0.207）m/s，右葉組VTQ參考值為（2.33±0.196）m/s，比較早期肝硬化肝臟左、右葉VTQ值有統(tǒng)計(jì)學(xué)意義（p0.05）。肝左葉組和右葉組VTQ值都呈升高趨勢，但右葉組標(biāo)準(zhǔn)差低于左葉組。 3.正常對照組肝臟VTQ參考值為（1.21±0.056）m/s，早期肝硬化組VTQ參考值為（2.33±0.196）m/s，對早期肝硬化組及正常對照組的VTQ值進(jìn)行獨(dú)立樣本t檢驗(yàn)，差異有顯著統(tǒng)計(jì)學(xué)意義（t=37.52,p0.001）。 結(jié)論: 1.正常人肝臟左、右葉VTQ值無明顯差異。 2.早期肝硬化患者肝臟左、右葉VTQ值差異較明顯。早期肝硬化患者肝左葉VTQ值均比右葉VTQ值高，，但肝右葉VTQ的準(zhǔn)確性、穩(wěn)定性明顯高于左葉。提示在早期肝硬化階段，測量右葉VTQ值更能準(zhǔn)確地反映出肝臟纖維化程度。 3.本研究測定了早期肝硬化組肝左、右葉的VTQ值，與正常對照組比較發(fā)現(xiàn)：早期肝硬化組肝臟組織硬度具有顯著變化，這對早期肝硬化的診斷具有顯著的臨床指導(dǎo)意義。 4.聲觸診組織量化技術(shù)能無創(chuàng)測定肝臟纖維化程度，是診斷早期肝硬化的一種有效方法，拓展了超聲在估測肝纖維化程度中的應(yīng)用。該技術(shù)簡單、無創(chuàng)，特異性較強(qiáng)，靈敏度較高，適合作為檢查肝臟的常規(guī)檢查。
[Abstract]:Objective: The changes of tissue hardness in early cirrhosis were studied by acoustic palpation and virtual touch tissue quantification (VTQQ) technique. To investigate whether the elastic index of the left and right lobes of liver in early cirrhosis is the same, to find the best location to reflect the elasticity of liver tissue in early liver cirrhosis, and to improve the diagnostic level of early cirrhosis by ultrasound imaging. It also provides reliable imaging basis for the diagnosis and clinical treatment of early liver cirrhosis, and further improves the value of ultrasonography in the application of diffuse liver disease, especially early cirrhosis. Methods: According to Scheuer standards. From September 2012 to December 2013, 51 patients (32 males and 19 females) with liver fibrosis stage S4 (male 32 and female 19) were selected from the second Hospital of Jilin University and underwent liver biopsy. The mean age was 46.41 鹵1.42 years, and 50 normal controls (male 29, female 21, mean age 43.12 鹵1.07). Brain diseases, normal liver and kidney function, and negative markers of hepatitis virus. The left liver of the two groups was measured by ACUSON S2000 color Doppler ultrasound diagnostic instrument and tissue quantification technique of acoustic palpation. The shear wave velocity of the right lobe was measured by VTQ. Data analysis: SPPS17.0 statistical analysis software was used. The measured data were expressed as mean 鹵standard deviation (x 鹵S). The two groups were left liver. The VTQ reference values between the right lobe and the right lobe were tested by paired sample t-test, the difference was statistically significant, and the measurement data between the two groups were statistically significant with independent sample t-test (P0.05). Results: 1. The reference values of VTQ in the left and right lobes of the normal control group were 1.22 鹵0.066 m / s and 1.21 鹵0.056 m / s, respectively. The VTQ value of right lobe was not statistically significant (p0.05). 2.The VTQ reference value of early cirrhosis liver Zuo Ye group was 2.79 鹵0.207 m / s, and the VTQ reference value of right lobe group was 2.33 鹵0.196 m / s. The VTQ values of left and right lobes were significantly higher in early liver cirrhosis than those in early liver cirrhosis. The VTQ values in Zuo Ye group and right lobe group were increased, but the standard deviation in right lobe group was lower than that in Zuo Ye group. 3. The reference value of VTQ in normal control group was 1.21 鹵0.056 m / s, and that in early cirrhosis group was 2.33 鹵0.196 m / s. The VTQ values of early cirrhosis group and normal control group were tested by independent t-test, and the difference was statistically significant (37.52%, P 0.001). Conclusion: 1. There was no significant difference in VTQ values between the left and right lobes of the normal liver. 2. The VTQ values of left and right lobes of liver were significantly different in patients with early liver cirrhosis. The VTQ value of Zuo Ye was higher than that of VTQ in right lobe of liver in early cirrhosis patients, but the accuracy of VTQ in right lobe of liver. The stability was significantly higher than that of Zuo Ye, suggesting that the VTQ value of right lobe could accurately reflect the degree of hepatic fibrosis in early stage of liver cirrhosis. 3. The VTQ values of left and right lobes of liver in early cirrhosis group were measured. Compared with normal control group, the hardness of liver tissue in early cirrhosis group was significantly changed. It has significant clinical significance in the diagnosis of early cirrhosis. 4. The quantitative technique of acoustic palpation can be used to detect the degree of liver fibrosis. It is an effective method for the diagnosis of early liver cirrhosis. It expands the application of ultrasound in estimating the degree of liver fibrosis. This technique is simple and non-invasive. It is suitable for routine examination of liver because of its strong specificity and high sensitivity.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R575.2

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