Wang Jinhuan, Wang Qiao, Yu Guoying, She Qilu, Zhang Wenyuan, Zhang Jiagang
Department of Ultrasound, Fourth People's Hospital of Qinghai Province, Xining, China.
Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Ultrasound Research and Education Institute, Tongji University School of Medicine, Shanghai, China.
J Ultrasound Med. 2018 Sep;37(9):2191-2199. doi: 10.1002/jum.14569. Epub 2018 Feb 24.
To explore the association between liver stiffness and the Child-Pugh classification of liver function by shear wave elastography (SWE).
A total of 116 patients with liver cirrhosis were divided into 3 groups according to the Child-Pugh classification prospectively. Conventional ultrasound imaging and SWE were performed for all patients. The associations of liver stiffness measured by SWE with ultrasound measurements, serum biochemical indicators, and the Child-Pugh classification were analyzed. Receiver operating characteristic curves were analyzed and compared to determine the ability of liver stiffness to diagnose cirrhosis.
Liver stiffness measured by SWE increased with an increasing Child-Pugh classification, internal diameter of the hepatic portal and splenic veins, spleen thickness, spleen length, total bilirubin level, and prothrombin time, which were positively correlated with the Child-Pugh classification (all P < .05). The albumin level and liver stiffness showed higher areas under the curve in comparison with other parameters for evaluating the Child-Pugh classification. Albumin and cholinesterase levels were negatively correlated with the Child-Pugh classification (P < .05). All of these indicators were significantly different between each pair of groups (all P < .05), except for the internal diameter of the hepatic portal vein, prothrombin time, and total bilirubin, and cholinesterase levels between groups B and C (P > 0.05) and the thickness and length of spleen and internal diameter of the splenic vein between groups A and B (P > 0.05). There were no differences among the groups for alanine aminotransferase, aspartate aminotransferase, and globulin levels.
Liver stiffness measured by SWE was correlated with the Child-Pugh classification, and it may be able to help evaluate liver function in patients with cirrhosis.
通过剪切波弹性成像（SWE）探讨肝脏硬度与肝功能Child-Pugh分级之间的关联。
前瞻性地将116例肝硬化患者根据Child-Pugh分级分为3组。对所有患者进行常规超声成像和SWE检查。分析SWE测量的肝脏硬度与超声测量值、血清生化指标以及Child-Pugh分级之间的关联。分析并比较受试者工作特征曲线，以确定肝脏硬度诊断肝硬化的能力。
SWE测量的肝脏硬度随着Child-Pugh分级、肝门静脉和脾静脉内径、脾厚度、脾长度、总胆红素水平及凝血酶原时间的增加而升高，这些指标与Child-Pugh分级呈正相关（均P<0.05）。与评估Child-Pugh分级的其他参数相比，白蛋白水平和肝脏硬度的曲线下面积更高。白蛋白和胆碱酯酶水平与Child-Pugh分级呈负相关（P<0.05）。除肝门静脉内径、凝血酶原时间、总胆红素以及B组和C组之间的胆碱酯酶水平（P>0.05），以及A组和B组之间的脾厚度、脾长度和脾静脉内径（P>0.05）外，所有这些指标在各组之间均有显著差异（均P<0.05）。各组间丙氨酸氨基转移酶、天冬氨酸氨基转移酶和球蛋白水平无差异。
SWE测量的肝脏硬度与Child-Pugh分级相关，可能有助于评估肝硬化患者的肝功能。
