本文選題：聲輻射力脈沖成像 + S指數(shù)　； 參考：《蘭州大學(xué)》2014年碩士論文

【摘要】：目的評價聲輻射力脈沖成像(ARFI)技術(shù)與血清肝纖維化診斷模型S指數(shù)單獨及聯(lián)合應(yīng)用在家兔肝纖維化診斷中的價值。 方法40只家兔隨機(jī)分為實驗組(32只)和對照組(8只),實驗組經(jīng)頸部皮下注射5%硫代乙酰胺(TAA)制作肝纖維化模型,首劑1.5ml/kg,以后每次1ml/kg,每周2次；對照組經(jīng)頸部皮下注射同等劑量的生理鹽水。于造模后第4、8、12周末分別隨機(jī)從實驗組中取8-10只、對照組中取2-3只家兔進(jìn)行聲輻射力脈沖成像檢查,記錄肝臟剪切波速度(shear wave velocity, SWV),并抽取兔耳緣靜脈血4ml行血清生化檢查和血小板計數(shù),計算S指數(shù),隨后處死家兔,取其肝臟制作標(biāo)本行組織病理學(xué)檢查,采用受試者工作特征(ROC)曲線評價ARFI、S指數(shù)單項及聯(lián)合應(yīng)用對肝纖維程度的診斷價值。 結(jié)果29只家兔造模成功,肝纖維化分期S1-S4期者分別有10只、8只、7只、4只；3只家兔肝臟嚴(yán)重炎癥壞死而無纖維化。37只家兔均成功完成ARFI檢測。肝纖維化分期SWV和S指數(shù)的診斷界值分別為S1期SWV1.32m/s, S指數(shù)0.02；S2期SWV1.62m/s, S指數(shù)0.04；S3期SWV1.96m/s, S指數(shù)0.11；S4期SWV2.04m/s, S指數(shù)1.84,SWV和S指數(shù)均隨著肝纖維化程度的增加而增大,各期測值均有統(tǒng)計學(xué)意義(P0.05)。SWV與S指數(shù)均與肝纖維化病理分期存在相關(guān),相關(guān)系數(shù)分別為0.724和0.472(P0.001)。ARFI與S指數(shù)診斷家兔肝纖維化S≥S2期的ROC曲線下面積為0.868、0.753；S≥S3期的ROC曲線下面積為0.822、0.706；S=S4期的ROC曲線下面積為0.886、0.735。ARFI聯(lián)合S指數(shù)診斷肝纖維化S≥S3期的ROC曲線下面積為0.864,大于單獨ARFI或S指數(shù)診斷。 結(jié)論1.采用TAA皮下注射的方法能夠成功獲得兔肝纖維化模型：2.ARFI與S指數(shù)均可用于肝纖維化的無創(chuàng)診斷,ARFI較S指數(shù)能更準(zhǔn)確的定量診斷肝纖維化分期,二者聯(lián)合有助于提高對顯著肝纖維化診斷的準(zhǔn)確性。
[Abstract]:Objective to evaluate the diagnostic value of acoustic radiation power pulse imaging (ARFI) technique and serum hepatic fibrosis model S index in the diagnosis of hepatic fibrosis in rabbits. Methods Forty rabbits were randomly divided into experimental group (n = 32) and control group (n = 8). The experimental group was injected subcutaneously with 5% thioacetamide (TAA) to make hepatic fibrosis model. The control group was subcutaneously injected with the same dose of normal saline through the neck. 8-10 rabbits were randomly selected from the experimental group at the end of 812 weeks after modeling, and 2-3 rabbits from the control group were examined by acoustic radiation pulse imaging. The shear wave velocity of the liver was recorded, and the blood 4ml of the rabbit auricular vein was extracted for serum biochemical examination and platelet count, then the S index was calculated. Then the rabbits were killed and their liver specimens were taken for histopathological examination. The diagnostic value of ARFI S index single item and combined application in liver fiber degree was evaluated by using the operating characteristics of the subjects (ROC) curve. Results the model of 29 rabbits was successfully established, and ARFI was detected successfully in 10, 8, 7, 4, 3, 3 and 37 non-fibrotic rabbits in the S1-S4 stage of hepatic fibrosis, respectively. The diagnostic cutoff values of SWV and S index in hepatic fibrosis stage were SWV 1.32 m / s in S1 stage, SWV 1.62 m / s in S index 0.02 and S2 stage, SWV 1.96 mr / s in S index 0.04 and S3 phase, SWV 2.04m / s in S index 0.11 and S4 stage, S index 1.84SWV and S index increased with the increase of liver fibrosis. There was a significant correlation between P0.05, SWV and S index and the pathological stage of hepatic fibrosis. Correlation coefficient was 0.724 and 0.472(P0.001).ARFI and S index were used to diagnose the area under the ROC curve of S 鈮，

本文編號：1820668