彩色多普勒超声联合Fibroscan评分系统在慢性乙肝纤维化诊断中的应用研究

本研究探讨了彩色多普勒超声联合Fibroscan评分系统在慢性乙肝纤维化诊断中的应用价值。选取行超声引导下肝穿刺活检的慢性乙肝患者300例,其中235例有肝纤维化(观察组)和65例无肝纤维化(对照组),统计分析了这两组患者和不同肝纤维化分期患者的彩色多普勒超声参数[门静脉主干内径(mPVD)、脾静脉内径(SVD)、门静脉血流量(mPBF)、门静脉主干平均血流速度(mPVm)、门静脉淤血指数(CI)、脾静脉平均血流速度(sVm)、脾静脉血流量(sVBF)]和肝脏硬度值(LSM)。结果显示,各参数联合诊断CHB肝纤维化的AUC最高,为0.876(P<0.05);SVD、mPVD、CI、LSM与肝纤维化分期呈正相关,mPVm与肝纤维化分期呈负相关(P<0.05);LSM诊断肝纤维化分期的AUC最大(P<0.05)。可见采用彩色多普勒超声与FibroScan定向瞬时弹性成像系统检测SVD、mPVD、CI、mPVm、LSM参数可诊断CHB肝纤维化,且各参数均与肝纤维化程度密切相关,有望成为评估肝纤维化及严重程度的无创性检测方法。

Application of Color Doppler Ultrasound Combined with Fibroscan Scoring System in the Diagnosis of Chronic Hepatitis B Fibrosis

To explore the application value of color Doppler ultrasound combined with Fibroscan scoring system in the diagnosis of chronic hepatitis B fibrosis,a total of 300 patients with chronic hepatitis B undergoing ultrasound-guided liver biopsy were selected,among which 235 patients had liver fibrosis(observation group)and 65 patients didn't have liver fibrosis(control group).The color Doppler ultrasound parameters[including main portal vein diameter(mPVD),splenic vein diameter(SVD),main portal vein blood flow(mPBF),mean velocity of main portal vein(mPVm),portal vein congestion index(CI),mean velocity of splenic vein(sVm),splenic vein blood flow(sVBF)]and liver stiffness measurement(LSM)of two groups were statistically analyzed,as well as the parameters between different liver fibrosis stages.The results showed that the AUC of combined diagnosis of CHB liver fibrosis was the highest,which was 0.876(P<0.05).SVD,mPVD,CI,LSM were positively correlated with liver fibrosis stage,mPVm was negatively correlated with liver fibrosis stage(P<0.05).The AUC of liver fibrosis stage diagnosed by LSM was the largest(P<0.05).It can be seen that using color Doppler ultrasound and FibroScan directional instantaneous elastography system, which detected SVD, mPVD, CI, mPVm, and LSM, can effectively diagnose CHB liver fibrosis. And each parameter is closely related to the degree of liver fibrosis. The combined detection is expected to be a non-invasive method for evaluating liver fibrosis and severity.