首 页   本刊简介  编委会  审稿专家  在线期刊  写作规范  广告合作  联系我们
您现在的位置:首页 => 在线期刊 => 2013年 5期 => 肝纤维化和肝硬化 =>高频超声观察慢性肝炎肝实质形态对..
高频超声观察慢性肝炎肝实质形态对诊断肝纤维化的临床价值
Low-/high-frequency ultrasound study of liver parenchyma morphology to determine diagnostic utility for extent of liver fibrosis in patients with chronic hepatitis
文章发布日期:2013年05月04日  来源:  作者:林健玲  点击次数:3113次  下载次数:551次

调整字体大小:

(此处下载失败可以在在线预览处保存副本或者右键另存为)

【摘要】:目的探讨高、低频超声所观察肝实质形态的细微变化与肝组织纤维化的关系。方法用高、低频超声观察216例慢性乙型肝炎肝实质形态的表现并对肝活组织进行纤维化程度的判断(从S0的无纤维化到S4的肝硬化)。高、低频超声依点、线状回声的不同表现分为5级(细短线、稍粗短线、粗短线、粗条纹、索条纹)。卡方检验判断组间的显著性差异,Sperman相关来判断超声表现与纤维化的关系程度。结果S1到S4肝实质形态的超声表现为细短线向粗短线、粗条纹、索条纹发展。在S1与S2之间高、低频超声有不同的肝实质形态表现,S3与S4则没有显著的区别。高、低频超声的肝实质形态改变均与肝纤维化程度呈正相关(r=0.5513、0.4858), 高频较低频超声具有更高的结节检出率(61.67% vs. 27.31%;χ2=49.96,P<0.01),与肝纤维化程度呈正相关(r=0.54372、0.30208)。结论高、低频超声均能检测到肝组织纤维化的存在,并能判断肝纤维化的程度。高频超声检测肝纤维化结节具有更高的精确性。
【Abstract】:ObjectiveTo determine whether subtle changes in hyperechoic findings from low-/high-frequency ultrasound analysis of liver biopsy specimens from patients with chronic hepatitis correlate with differences in liver parenchyma morphology associated with presence and extent of fibrosis. MethodsSpatially-matched liver parenchyma biopsy specimens from 216 patients with chronic hepatitis (hepatitis b virus infection) were subjected to both low- and high-frequency ultrasound, as well as conventional histological analysis, which was used to score the extent of fibrosis (progressive staging: S1, no fibrosis, through S4, cirrhosis). The low- and high-frequency point-like echo and echo performance, respectively, were used to classify samples among one of five fractionating features (fine, thick, coarse/crude, irregular/nonlinear, cable stripes). Significance of intergroup differences was assessed by Chi-squared test. Spearman′s correlation coefficient was used to assess the correlation between the ultrasound findings and histological fibrosis stage. ResultsThe changes in echoic findings paralleled progressive deterioration in fibrosis stage: from fine to thicker, uneven, and cable stripe shapes along stages S0 to S4. Both the low- and high-frequency ultrasound findings could differentiate changes in liver parenchyma morphology associated with S1 (low-frequency: χ2=76.52 vs. S2, χ2=71.91 vs. S3, χ2=59.43 vs. S4; high-frequency: χ2=76.52 vs. S2, χ2=71.91 vs. S3, χ2=59.43 vs. S4; all P<0.01) and S2 (low-frequency: χ2=5.17 vs. S3, χ2=21.25 vs. S4; high frequency: χ2=23.67 vs. S3, χ2=3480 vs. S4; all P<0.01). There were no significant differences associated with either low- or high-frequency ultrasound findings for S3 or S4. The low- and high-frequency ultrasound liver parenchyma fractionation were postively correlated to liver fibrosis staging (r=04858 and r=0.5513, respectively). The high-frequency ultrasound had a significantly higher positive rate of detecting nodules than the low-frequency ultrasound (61.67% vs. 27.31%; χ2=49.96, P<0.01), and the positive rates were positively correlated with liver fibrosis stage (low-frequency: r=0.5437; high-frequency: r=0.3021). ConclusionWhile both low- and high-frequency ultrasound allow for detection of liver fibrosis and differentiation of some fibrotic stages, the high-frequency ultrasound findings are superior for detecting fibrotic nodules.
【关键字】:超声检查;肝炎,乙型,慢性;肝硬化
【Key words】:ultrasonography; hepatitis B, chronic; liver cirrhosis
【引证本文】:

地址:长春市东民主大街519号《临床肝胆病杂志》编辑部 邮编:130061 电话:0431-88782542/3542
临床肝胆病杂志 版权所有 Copyright © 2009 - 2013 Lcgdbzz.org. All Rights Reserv 吉ICP备10000617号

吉公网安备 22010402000041号