Departement of Internal Medicine 1, University of Erlangen.
Institut of Pathology, Universtiy of Erlangen.
Ultraschall Med. 2014 Feb;35(1):44-50. doi: 10.1055/s-0033-1350170. Epub 2014 Feb 7.
To evaluate the diagnostic value of acoustic radiation force impulse (ARFI) and high-frequency ultrasound of the liver surface, using histology as a gold standard for the diagnosis of compensated liver cirrhosis.
73 patients without ascites undergoing liver biopsy were included in the study. The left and right liver lobes were examined with ARFI and high-frequency ultrasound. Liver surface irregularity was quantified using image analysis software to calculate the difference between the real surface and the approximated physiological surface through a 20 mm standardized line.
There is a significant difference between cirrhotic and non-cirrhotic patients for both quantified liver surface (QLS) and ARFI (p < 0.001). The mean values for QLS of the left lobe were 0.71 ± 0.24 mm and 1.17 ± 0.80 mm, of the right lobe 0.56 ± 0.26 mm and 0.87 ± 0.26 mm for non-cirrhotic and cirrhotic patients, respectively. The mean values of ARFI measurements of the left lobe were 2.04 ± 0.76 m/s and 2.85 ± 0.81 m/s, of the right lobe 1.65 ± 0.61 m/s and 3.02 ± 0.77 m/s for non-cirrhotic and cirrhotic patients, respectively. Diagnostic accuracy (AUROC) was 0.78/0.80 for QLS and 0.77/0.91 for ARFI of the left/right lobe, respectively. ARFI of the right lobe is significantly better than ARFI of the left (p = 0.023) or QLS of the left (p = 0.025)/right (p = 0.046) lobe of the liver.
Assessment of liver surface irregularity by high-frequency ultrasound (QLS) is a useful diagnostic test for the assessment of compensated liver cirrhosis. ARFI of the right liver lobe is significantly better than high-frequency ultrasound (QLS of the left/right lobe of the liver) and ARFI of the left lobe of the liver.
以组织学为诊断代偿性肝硬化的金标准，评估声辐射力脉冲（ARFI）和高频超声对肝脏表面的诊断价值。
纳入 73 例无腹水行肝活检的患者。使用 ARFI 和高频超声检查左、右肝叶。使用图像分析软件对肝表面不规则性进行定量，通过 20mm 标准化线计算真实表面与近似生理表面之间的差异。
肝硬化和非肝硬化患者的定量肝表面（QLS）和 ARFI 均有显著差异（p<0.001）。左叶 QLS 的平均值分别为 0.71±0.24mm 和 1.17±0.80mm，右叶分别为 0.56±0.26mm 和 0.87±0.26mm。左叶 ARFI 测量值的平均值分别为 2.04±0.76m/s 和 2.85±0.81m/s，右叶分别为 1.65±0.61m/s 和 3.02±0.77m/s。左/右叶 QLS 和 ARFI 的诊断准确性（AUROC）分别为 0.78/0.80 和 0.77/0.91。右叶 ARFI 明显优于左叶 ARFI（p=0.023）或左/右叶 QLS（p=0.025/p=0.046）。
高频超声（QLS）评估肝表面不规则性是评估代偿性肝硬化的有用诊断试验。右肝叶 ARFI 明显优于高频超声（左/右肝叶 QLS）和左肝叶 ARFI。
