二维超声分级评分在慢性乙型病毒性肝炎肝纤维化分级的应用价值

新发传染病电子杂志 ›› 2017, Vol. 2 ›› Issue (4): 205-209.

二维超声分级评分在慢性乙型病毒性肝炎肝纤维化分级的应用价值

骆永芳¹, 董常峰¹, 张定平¹, 张宇¹, 刘映霞², 张新宇³, 陈昕³

1.深圳市第三人民医院超声科,广东深圳 518112;
2.深圳市第三人民医院感染科,广东深圳 518112;
3.深圳大学生物医学工程学院,广东深圳 518037

收稿日期:2017-05-11 出版日期:2017-11-30 发布日期:2020-07-14
通讯作者: 董常峰,Email：dongchangfeng7@163.com
基金资助:
国家自然科学基金重点项目（61031003）、国家自然科学基金面上项目（81471735, 81570552）

The usefulness of 2 dimensional ultrasound scoring in grading of liver fibrosis in patients with chronic hepatitis B

LUO Yong-fang¹, DONG Chang-feng¹, ZHANG Ding-ping¹, ZHANG Yu¹, LIU Ying-xia², ZHANG Xin-yu³, CHEN-Xin³

1. Department of Ultrasound,The Third People’s Hospital of Shenzhen,Guangdong Shenzhen 518112 China;
2. Department of Infection,The Third People’s Hospital of Shenzhen,Guangdong Shenzhen 518112 China;
3. School of Biomedical Engineering, Shenzhen University, Guangdong Shenzhen 518037 China

Received:2017-05-11 Online:2017-11-30 Published:2020-07-14

摘要/Abstract

摘要： 目的依据慢性乙型肝炎患者肝脏二维超声声像图特征将其诊断结果进行半定量评分,分析二维超声分级评分在慢性乙型肝炎肝纤维化分级诊断中的价值。方法 140例乙肝病毒感染者被纳入研究,按照活检病理结果 ,以METAVIR分类法将其分为4组(F1~F4组),随机选择47例健康志愿者作为对照组(F0组),所有受试者接受超声检查。由两位在肝病专科医院工作至少5年的超声医生对原始图像、数据进行双盲二维超声分级评分。结果二维超声分级评分与肝纤维化病理分期的等级相关系数两位研究者分别是r=0.883、r=0.881,二者讨论后重新认定评分相关系数r=0.910(P<0.001);诊断明显肝纤维化(≥F2)的灵敏度(sensitivity)、特异度(specificity)、一致率分别为83.2%、96.3%、88.8%;诊断重度肝纤维化(≥F3)的灵敏度、特异度、一致率分别为75.4%、93.2%、86.6%; 诊断肝硬化(F4)的灵敏度、特异度、一致率分别为97.7%、88.2%、90.4%。结论二维超声分级评分在慢性乙型肝炎肝纤维化分级诊断方面与病理结果相关度高,诊断具有临床意义的F2级别以上肝纤维化特异度高,据此,在临床上可减少侵入性的肝穿刺活检操作。它将传统的肝脏二维超声声像图特征进行半定量转化,操作简便,值得推广应用。

关键词: 二维超声, 分级评分, 肝纤维化, 肝硬化

Abstract: Objective To investigate the usefulness of 2 dimensional ultrasound scoring based on semi-quantitative analysis of ultrasound images in grading of liver fibrosis in patients with chronic hepatitis B (CHB). Methods A total of 140 patients were enrolled in the study and divided into 4 groups(F1-F4) according to pathological grading using METAVIR scores system; 47 randomly chose healthy volunteers were enrolled as the control group(F0). An ultrasound examination were double-blindly evaluated by 2 radiologists who have more than 5 years’ working experiences in one hospital specialized in hepatic diseases. Results The liver fibrosis grade correlation coefficient between ultrasound images and histological images was assessed as 0.883 and 0.881 respectively by the two radiologists and combined and finalized as 0.910(P<0.0001). The sensitivity, specificity and consistency of moderate fibrosis (group F2, F3 and F4) grading are 83.2%, 96.3%, and 88.8%, respectively. The sensitivity, specificity and consistency of severe fibrosis(group F3 and F4) grading are 75.4%, 93.2%, and 86.6%, respectively and those for cirrhosis (group F4) are 97.7%, 88.2%, and 90.4%, respectively. Conclusion 2D-mode ultrasound scoring is highly correlated with pathological grading of liver fibrosis in patients with chronic hepatitis B(CHB). High specificity was demonstrated ingrading of liver fibrosis ≥F2 groups, therefore, less invasive procedure of liver biopsy is feasible. 2D-mode ultrasound scoring based on semi-quantitative analysis of ultrasound images is easy to obtain, and worth applying.

Key words: 2D-mode ultrasound, Ultrasound scoring, Hepatic fibrosis, Cirrhosis

骆永芳, 董常峰, 张定平, 张宇, 刘映霞, 张新宇, 陈昕. 二维超声分级评分在慢性乙型病毒性肝炎肝纤维化分级的应用价值[J]. 新发传染病电子杂志, 2017, 2(4): 205-209.

LUO Yong-fang, DONG Chang-feng, ZHANG Ding-ping, ZHANG Yu, LIU Ying-xia, ZHANG Xin-yu, CHEN-Xin. The usefulness of 2 dimensional ultrasound scoring in grading of liver fibrosis in patients with chronic hepatitis B[J]. Electronic Journal of Emerging Infectious Diseases, 2017, 2(4): 205-209.

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