| Part I:Correlative Study Between virtual touch tissue quantification and Traditional Chinese Medicine Syndromes of Fatty LiverObjective:To investigate the characteristics of the shear wave velocity (SWV) with virtual touch tissue quant ification (VTQ), and also the correlation between the the liver SWV and the traditional Chinese medicine (TCM) syndrome in fatty liver patients. The present study can provide objective and reliable evidence for diagnosis and treatment of the fatty liver disease.Methods:The185patients were selected in the China-Japan Friendship from December2011to August2012(92men and93women, mean age48.32±13.14years).Multiple imaging examinations and laboratory findings helped to exclude other liver diseases, kidney diseases, malignant tumor and other terminal diseases. Meanwhile, parturients and heavy drinkers were also excluded.The recruited patients were divided into mild fatty liver group (n=69), moderate fatty liver group (n=86)and severe fatty liver group (n=30) on the basis of the traditional ultrasound diagnostic and classification criteria.ACUSON S2000ultrasound system (4C12.5～7.5MHz convex) offered by Siemens was used to evaluate SWVs. In each patient liver stiffness was measured by means of VTQ in the right liver lobe,4-5cm below the napes and lcm below the liver capsule, by intercostal approach, with the patient laying in left decubitus, while the patients were asked to stop breathing for a moment, in orther to minimize breathing motion. In each patient at least5valid SWV measurements were performed in liver and the average values were calculated, the rusult being expressed in meters/second (m/s).According to the <TCM Digestive Disease Clinic Guide>(2006edition),185patients were divided into Phlegm Accumulation certificate (n=58), turbid phlegm and blood stasis (n=18), liver depression and qi stagnation (n=30), Spleen wet Yun certificate (n=44), Damp volts Card (n=35).The SWV characteristics in fatty liver patients of different degrees of fatty liver and TCM syndrome were analyzed, respectively. Besides, the correlation were assessed between the liver SWV and TCM syndrome. Results:In general, fatty liver syndromes mainly include syndrome of Phlegm Accumulation certificate and Spleen wet Yun card. The Phlegm Accumulation certificate were common moderate fatty liver, turbid phlegm and blood stasis and Damp volts Card were common severe fatty liver, and the liver depression and qi stagnation and Spleen wet Yun certificate were common mild fatty liver. Mild fatty liver were mainly in syndrome of Spleen wet Yun certificate, moderate fatty liver were mainly in syndrome of Phlegm Accumulation certificate, and the severe fatty liver were mainly in syndrome of Damp volts Card.The SWV values of the mild fatty group, moderate fatty liver group and severe fatty liver group were (1.01±0.06) m/s,(1.57±0.65) m/s and (0.81±0.07) m/s, respectively, which had a significant difference among the three groups (mild fatty liver group verse moderate fatty liver group,P=0.000; mild fatty liver group verse severe fatty liver group, P=0.033; moderate fatty liver group verse severe fatty liver group, P=0.000).The SWV values of Phlegm Accumulation certificate, turbid phlegm and blood stasis, liver depression and qi stagnation, Spleen wet Yun certificate and Damp volts Card were (1.45±0.67) m/s,(0.92±0.14) m/s,(1.17±0.45) m/s,(1.20±0.46) m/s and (1.14±0.48) m/s, respectively. There were the statistical significance between the Phlegm Accumulation certificate and the other groups (P=0.000, P=0.018, P=0.020, P=0.070), but no sigrufcant differences was found among other four groups. A low correlation between the SWV of the fatty liver and the TCM syndrome (r=-0.256, P=0.000) was obtained by Spearman rank correlation analysis.Conclusion:The SWV of the fatty liver and the TCM syndrome had a certain correlation, which provide objective and reliable evidence for diagnosis and treatment of the fatty liver disease.This study could help to promote the diagnosis development of integrated Chinese and Western medicine. Part II:Correlation Study on Virtual Touch Tissue Quantification and the Pathological Grading of Liver Fibrosis in Chronic Hepatitis BObjective:To investigate the correlation between virtual touch tissue quantification (VTQ) and the pathological grading of liver fibrosis in chronic hepatitis B.Methods:64chronic hepatitis B patients (the chronic hepatitis group;51men and13women, mean age41.25±10.66years)and40healthy volunteers (the controlled group;18men and22women, mean age43.63±15.79years) were collected. The patients in the chronic hepatitis group were underwent liver biopsy.According to the hepatic fibrosis degree, the patients in the test group were classified into stage0,1,2,3and4. The liver shear wave velocities (SWV) of all the participant were measured by VTQ. The spssl7.0statistical software was used to analysis. The cut-off values were determined by an analysis of receiver operating characteristic (ROC) curve.Results:The mean SWV was1.04±0.13m/s in the controlled group. The SWV in stages0,1,2,3, and4were1.17±0.08m/s,1.33±0.32m/s,1.53±0.32m/s,2.09±0.54m/s,2.18±0.70m/s, respectively. There was a significantly difference in SWV between the controlled group and the chronic hepatitis group (F=34.97, P=0.000). The SWV were s ignif icant ly different not only between stages0/1/2, and3, but also between0/1/2and4(F=8.87, P=0.000). A positive correlation was observed between the liver fibrosis and the SWV in the chronic hepatitis group (r=0.67, P=0.000). When a cut off value was set at1.43m/s, area under the receiver operating characteristic curve (AUROC) was0.875. The sensitivity and specificity were100%and62.5%.Conclusions:SWV has a better correlation with liver fibrosis. VTQ can make an accurate assessment for stage3and stage4of the chronic hepatitis B. Therefore, VTQ can be used as a noninvasive and reliable diagnostic indicator for thechronic hepatitis B. |
PDF Full Text Request