The Clinical Value Of Sound Speed Correction In Early Diagnosis Of Liver Fibrosis And Staging

Objectives The study aimed to measure the zone speed index of hepatic tissue at different position of patients with hepatic fibrosis by sound speed correction technology, to choose the best position for measuring the zone speed index, to preliminary discussion on the value in evaluating liver fibrosis staging by zone speed index and provide quantitative basis for the early diagnosis of hepatic fibrosis.Methods ninety-three volunteers of normal control group were collected who liver function and ultrasound examination of liver is normal from September 2014 to February2016 in North China University of Science and Technology affiliated hospital. At the same time one hundred and twenty-one volunteers of hepatic fibrosis group were collected who hepatic fibrosis confirmed by pathology in North China University of Science and Technology affiliated hospital and Tangshan infectious disease hospital. Then hepatic fibrosis group was further divided into S0 group, S1 group, S2 group, S3 group and S4 group according to the pathological staging. The zone speed index of the normal control group and the hepatic fibrosis group(different stages) was measured. The operator, in the first place, measured zone speed index in the left hepatic lobe abdominal aorta section near areas under the liver capsule; And then the probe was placed at right anterior axillary line into the seventh or eighth rib, zone speed index was measured while the interested box under the right liver lobe capsule 0cm, 1 cm, 2cm, >3cm, respectively. Zone speed index of each position was measured by five repeated and the average zone speed index was accepted. Zone speed index of hepatic tissue of different parts in the same group was compared; the change of zone speed index of hepatic tissue among different groups was analyzed, and the receiver-operating characteristic curve(ROC curve) between different groups while the difference was statistically significant according to the gold standard by pathological results was constructed. The threshold of zone speed index for hepatic fibrosis staging was obtained by the ROC curve.Results 1 The right liver lobe was the best position for measuring zone speed index of liver tissue. 2 The mean value of ZSI in hepatic fibrosis group was higher than that in normal control group?the mean value of ZSI in S2 group was higher than that in S1 group and the mean value of ZSI in S4 group was higher than that in S3 group, the difference was statistically significant(P<0.05). 3 There was no statistically significant difference between normal control group and S0 group, S0 group and S1 group, S2 group and S3group(P>0.05). 4 Normal control group and hepatic fibrosis group, normal control group-S1 group and S2 group, S2-S3 group and S4 group critical ZSI values were 25 m / s, 25 m /s, 45 m / s, respectively. The areas under the ROC curve were 0.824,0.879 and 0.906,respectively. Youden's indexes were 0.533, 0.630 and 0.697, respectively. Sensitivities were 69.4%, 84.3% and 81.5%, respectively. Specificities were 83.9%, 78.7% and 88.2%,respectively. 5 There was no statistically significant difference of ZSI at different position in the same group(P > 0.05).Conclusions 1 The more serious hepatic fibrosis, the higher zone speed index. 2 Sound speed correction technology could provide the basis for the early diagnosis of hepatic fibrosis and its staging: Normal control group and hepatic fibrosis group critical ZSI value was 25 m / s, normal control group- S1 group and S2-S3 group critical ZSI value was 25m/ s, S2-S3 group and S4 group critical ZSI value was 45 m / s. 3 The right liver lobe is the best position for measuring the zone speed index of liver tissue.