Diagnostic Value Of Sound Velocity Tissue Quantification In Schistosomiasis Hepatic Fibrosis

Objects1. To establish methods and related factors of detecting liver zone speed index (ZSI), obtaining zone sound speed (ZSS) by using sound speed tissue quantification (STQ) technology in the schistosoma japonicum.2.To discuss the value of STQ for assessment of schistosomiasis liver injury degree, applying STQ for all levels (refering to Advisory Council of ultrasonic diagnosis of schistosomiasis liver, held in Cairo WHO/TDR,October 1990, developed grading standard to divided into 0,1, II, III),ZSI values of schistosome infection were detected.Methods1. Excluding other liver injury diseases such as fatty liver, hepatitis, alcoholic liver cirrhosis after definite diagnosis, selected satisfactory ones to conventional ultrasonic testing, which can be divided into 0 to grade III, referring to the ultrasonic diagnosis of schistosomiasis Advisory Council held in Cairo, October 1990 by WHO/TDR, developed schistosomiasis liver grading standard, and homologous group 0, group I, group II and group III will be.2. Liver ZSI were obtained in 39 schistosomiasis of group 0 using STQ with ZONARE Zone Ultra. The 39 cases were detecting ZSI at 0cm and 1cm below liver capsule in left and right lobe, the corresponding ZSS values can be obtained. Calculate the mean value after 5 times of each part as the record result of measurement. The achievement rate and intra-group correlation coefficient (ICC) of each position was calculated to select a suitable position. Analyze the relationship between age, sex and ZSS.3. At the same time detect ZSI of 39 cases of group 0 in the right lobe at different depths (2cm,3cm below the liver capsule). Analysis of variance was used to compare liver ZSS value differences in the depth of interest (0cm,1cm,2cm,3cm subcapsular in the right lobe of liver).4. Apply STQ technology in 39 cases of group 0,28 cases of group 1,27 cases of group II,26 cases of group III for ZSI 1cm subcapsular in right lobe of liver. Calculate the corresponding ZSS value, comparing by analysis of variance.Compare the obtained ZSS value of two operators.Results1. STQ has high stability in the detection of liver ZSI value.39 cases of the group 0 successfully obtained ZSS in right lobe of liver.9 cases of 0 cm subcapsular left liver lobe region,16 cases of 1 cm subcapsular left liver lobe region did not get satisfactory ZSI value (because the left liver lobe not only has great morphological variation, but also contains a lot of coarse pipeline structure and even adjust the position with minimum region of interest that still contains non hepatic tissues, so the complete detection cannot be accomplished), χ2 test is used to the data obtained, that the detection accuracy of left and right hepatic lobe is statistically significant (χ2=17.50, P<0.05). The right hepatic lobe detection accuracy was significantly higher than that of the left lobe. Age and sex had no significant correlation with the liver ZSS value of early schistosome infection.2. ZSS in different depth subcapsular the right liver lobe of group 0 tested by analysis of variance obtained that:ZSS was negatively correlated with the depth of detection, with not good correlation (P<0.05, r=0.34).3. ZSS of the region of 1 cm below right liver lobe capsule of four groups are analysed by single factor variance analysis:compared with group 0, ZSS value of group I had no significantly increase (1545.23±6.77vsl548.71±8.66), ZSS value of group II and group III increased significantly (1565.11±7.47±1569.38±9.49vs1545.23±6.77) group II and group III ZSS value had no statistically significant difference. The coefficient of variation of two operators measuring the ZSS values was 0.203.Conclusions1. ZSS of schistosomiasis patients with grade 0 had no significant difference between left and right liver lobe, the right liver lobe detection success rate was significantly higher than the left one. The detection depth was negatively related with ZSS.2. STQ imaging has good stability and repetition rate of measurement of liver ZSI.ZSS value can be obtained automatically with high accuracy, it will be used as a new non-invasive method for quantitative evaluation of liver tissue hardness, reflecting the degree of liver fibrosis.3. STQ technology can reflect the different stages of liver injury with Schistosoma infected by measuring the ZSI value. It has the advantages of non-invasive, rapid and high accuracy, and it is expected to become effective index as clinical quantitative evaluation of schistosomiasis hepatic damage degree.