| Objective:To comprehensive evaluation the hardness of liver and spleen by applying virtual touch tiss quantification(VTQ)technology in measuring the shear wave velocity(SWV) of liver and spleen,further explore the clinical application value of VTQ technology in liver fibrosis stage.Methods:The study subjects were performed the measurements of liver and spleen shear wave velocity by using a ultrasonic instrument named ACUSON S2000, and were composed with 30 control group and 80 patients with chronic hepatitis b. Analyzed correlations between SWV and pathological grades of the liver and spleen,and divided the SWV range in liver and spleen of by applying subjects’ receiver-operating characteristic curve.The diagnostic value of liver fibrosis in SWV was expressed by specificity and sensitivity,using ROC curve to determine the threshold value of corresponding the shear wave velocity to different fibrosis stages,the corresponding areas under receiver operated characteristic curve area(area under the ROC, AUROC) >0.5,if AUROC closer 1, higher diagnostic accuracy.Results:The chronic hepatitis b patients with liver fibrosis S0 period has no statistically significant difference with 30 case control group in SWV of liver,but has statisticallysignificant difference in SWV of spleen.Liver inflammation activity(r=0.69,P=0.00) and fibrosis pathological stages(r=0.84,P=0.00) in 80 cases patients of chronic hepatitis b increased with SWV value of liver.AUROC≥S1,AUROC≥S2,AUROC≥S3,AUROC=S4,the threshold value that the AUROC corresponding were1.40m/s,1.57m/s,2.15m/s,2.53m/s,The diagnostic sensitivity respectively were 92.8%、68.9%、85.7%、100%,the best diagnostic threshold was sensitivity+specificity-1,Statistical analysis shows if SWV of liver was2.53m/s,there has the best sensitivity and specificity in diagnosing pathological staging grade 4 of liver fibrosis.Comparison between the three groups there was no significant difference between resistance index(RI) of hepatic artery(P>0.05).Pathological staging of liver fibrosis( r=0.68, P=0.00) had a significant linear relationship with the length to diameter of spleen,long diameter and short diameter of spleen and liver fibrosis stage had significantly positive correlation, or there had a certain correlation between long diameter and short diameter of spleen and degree of liver fibrosis.Liver inflammation activity(r=0.68,P=0.00) and fibrosis pathological stages had significantly positive correlation with SWV of spleen.AUROC≥S1,AUROC≥S2,AUROC≥S3,AUROC=S4,the threshold value that the AUROC corresponding were1.93m/s、2.29m/s、2.31m/s、2.47m/s,The diagnostic sensitivity respectively were 66.7%、53.3%、78.6%、100%,the best diagnostic threshold was sensitivity+specificity-1,Statistical analysis shows if SWV of liver was2.47m/s,there has the best sensitivity and specificity in diagnosing pathological staging grade 4 of liver fibrosis.Depicting ROC curve of liver and spleen’ s SWV value of 80 case patients with chronic hepatitis b,AUROC all close to 1in liver’ s fibrosis pathological stages S1、S2、S3 orS4,compared with application separately liver and spleen SWV value, United with SWV value,there had higher sensitivity and specificity.Conclusion:1.The best correlation factors of SWV value of liver and spleen was the degree of liver fibrosis,and rised with it serious.2.To staged the degree of liver fibrosis in chronic hepatitis b by using the VTQ technology measured SWV vlaue of liver and spleen,SWV vlaue of liver and spleen all had high positive correlation with liver’ s fibrosis pathological stages,compared with application separately liver and spleen SWV value, joint with SWV value could better reflect the degree of liver fibrosis.3.VTQ technique operated simplely and conveniently,and had good repeatability,was a kind of noninvasive and feasible new method of assessment the degree of liver fibrosis,and is expected to become the new indicators for noninvasive assessment of liver fibrosis stage diagnosis, had important clinical value. |
PDF Full Text Request