声触诊组织弹性成像技术、声触诊组织量化技术与 4 项血清纤维化指标对慢性乙型肝炎患者肝纤维化的诊断价值比较。

Comparison of Sound Touch Elastography, Sound Touch Quantify, and 4 Serum Fibrosis Indexes for the Diagnosis of Liver Fibrosis in Patients With Chronic Hepatitis B.

机构信息

Department of Ultrasound, Chenggong Hospital Affiliated to Xiamen University.

Department of Ultrasound, Traditional Chinese Medicine Hospital of Xiamen, Xiamen, China.

出版信息

Ultrasound Q. 2021 Jun 1;37(2):123-128. doi: 10.1097/RUQ.0000000000000485.

DOI:10.1097/RUQ.0000000000000485

PMID:34057912

Abstract

The aim of this research was to compare the use of shear wave elastography (sound touch elastography [STE] and sound touch quantify [STQ]) and serum liver fibrosis indexes in the evaluation and staging of chronic hepatitis B (CHB) liver fibrosis. Sound touch elastography is a form of 2-dimensional shear wave elastography, and STQ is a form of point shear wave elastography. Between June 2018 and March 2019, 122 patients with CHB were assessed using STE and STQ. Serum liver biomarkers tests were undertaken, and liver biopsy was performed, and these were used to assign a pathological stage based on the Scheuer scoring system. A receiver operating characteristic curve was used to analyze the diagnostic value of noninvasive methods for evaluating and staging liver fibrosis. The cutoff values of STE for liver fibrosis stages S2 to S4 were 8.85, 9.97, and 10.29 kPa, respectively, and the areas under the receiver operating characteristic (AUCs) curve were 0.703, 0.821, and 0.900, respectively. The cutoff values of STQ for liver fibrosis stages S2 to S4 were 11.31, 13.81, and 20.60 kPa, respectively, and the AUCs were 0.674, 0.807, and 0.893, respectively. The AUCs of STE and STQ in diagnosing fibrosis stage were significantly higher than those of liver serum biomarkers (P < 0.05). The AUCs for the ability of the aspartate transaminase-to-platelet ratio index, the fibrosis index based on the 4 factors, the King score, and the Forns index to diagnose S2 fibrosis were 0.502, 0.624, 0.542, and 0.616, respectively, and the AUCs for their ability to diagnose S4 fibrosis were 0.856, 0.861, 0.883, and 0.823, respectively. Both STE and STQ are noninvasive methods for the assessment of liver fibrosis in CHB patients, with better diagnostic performances than those of 4 serum fibrosis indexes.

摘要

本研究旨在比较剪切波弹性成像（声触诊组织弹性成像[STE]和声触诊量化[STQ]）与血清肝纤维化指标在慢性乙型肝炎（CHB）肝纤维化评估和分期中的应用。声触诊弹性成像是二维剪切波弹性成像的一种形式，STQ 是一种点剪切波弹性成像。2018 年 6 月至 2019 年 3 月，对 122 例 CHB 患者进行了 STE 和 STQ 评估。进行了血清肝生物标志物检测，并进行了肝活检，根据 Scheuer 评分系统对其进行了病理分期。采用受试者工作特征曲线分析了无创方法评估和分期肝纤维化的诊断价值。STE 诊断肝纤维化分期 S2 至 S4 的截断值分别为 8.85、9.97 和 10.29kPa，受试者工作特征（ROC）曲线下面积分别为 0.703、0.821 和 0.900。STQ 诊断肝纤维化分期 S2 至 S4 的截断值分别为 11.31、13.81 和 20.60kPa，ROC 曲线下面积分别为 0.674、0.807 和 0.893。STE 和 STQ 诊断纤维化分期的 AUC 显著高于血清肝生物标志物（P<0.05）。天冬氨酸转氨酶-血小板比值指数、基于 4 个因素的纤维化指数、King 评分和 Forns 指数诊断 S2 纤维化的 AUC 分别为 0.502、0.624、0.542 和 0.616，诊断 S4 纤维化的 AUC 分别为 0.856、0.861、0.883 和 0.823。STE 和 STQ 均为 CHB 患者肝纤维化评估的非侵入性方法，其诊断性能优于 4 种血清纤维化指标。