肝脏 ›› 2023, Vol. 28 ›› Issue (12): 1423-1425.

• 肝纤维化及肝硬化 • 上一篇    下一篇

FibroTouch与肝脏血流动力学变化对慢性乙型肝炎肝纤维化分期价值分析

陈勇良, 王永莎, 闫伟静, 陈敬兹, 潘丽, 李振燕   

  1. 050021 河北 石家庄市第五医院感染科(陈勇良,潘丽),影像科(王永莎,闫伟静,陈敬兹)
  • 收稿日期:2023-05-25 出版日期:2023-12-31 发布日期:2024-03-01
  • 通讯作者: 李振燕,Email:swycsl@163.com
  • 基金资助:
    石家庄市科学技术研究与发展计划(201201243) ;河北省医学科学研究课题计划(20221689)

An analysis on the value of FibroTouch and liver hemodynamic changes in staging liver fibrosis of chronic hepatitis B patients

CHEN Yong-liang1, WANG Yong-sha2, YAN Wei-jing2, CHEN Jing-zi2, PAN Li1, LI Zhen-yan2   

  1. 1. Department of Infectious Disease, Shijiazhuang Fifth Hospital, Hebei 050021, China;
    2. Department of Imaging, Shijiazhuang Fifth Hospital, Hebei 050021, China
  • Received:2023-05-25 Online:2023-12-31 Published:2024-03-01
  • Contact: LI Zhen-yan,Email: swycsl@163.com

摘要: 目的 探讨Fibro Touch与肝脏血流动力学软件(PMD)对慢性乙型肝炎患者肝纤维化程度的诊断价值。方法 将82例慢性乙型肝炎患者及32例正常人作为研究对象,应用FibroTouch检测肝脏硬度值(LSM);同时使用彩色多普勒超声检测门静脉、肝左静脉、肝中静脉、肝右静脉血流频谱波形,应用M型超声测量心率,所得血流频谱图像及心率上传至PMD系统内,计算出肝脏血流流动频率值(LBFF)。将FibroTouch检测LSM及PMD所测LBFF与肝穿刺活组织病理诊断对照。结果 82例慢性乙型肝炎患者肝纤维化分期1期33例,2期22例,3期10例,4期17例。114例研究对象的LSM 3.7~55.1 kPa,与肝纤维化分期呈显著正相关(r=0.811,P<0.01);肝脏LBFF 0~26 Hz,与肝纤维化分期呈显著正相关(r=0.831,P<0.01)。Fibro Touch检测结果显示,≥S1、≥S2、≥S3、=S4 LSM截断值分别为6.05、7.95、11.2、10.35 kPa,AUC分别为0.959、0.883、0.916、0.90;敏感度分别为89%、 93.9%、88.9%、100%;特异度分别为100%、78.5%、83.9%、73.2%。PMD检测结果显示,≥S1、≥S2、≥S3、=S4的LBFF截断值分别为1.233、1.99、3.8、5.815 Hz;AUC分别为0.899、0.939、0.944、0.972;敏感度分别为78%、78.8%、88.9%、88.2%;特异度分别为100%、83.1%、83.9%、95.9%。结论 FibroTouch与PMD作为无创检测肝纤维化方法,与肝纤维化分期具有良好的相关性,可较准确地评估肝脏纤维化程度。

关键词: FibroTouch, 肝脏血流动力学软件, 彩色多普勒超声, 门静脉, 肝静脉, 肝纤维化分期

Abstract: Objective To explore the diagnostic value of Fibro-Touch and “Liver Hemodynamics Software” (PMD) for the degree of liver fibrosis in chronic hepatitis B patients.Methods Eighty-two chronic hepatitis B patients and 32 normal individuals were selected as the study cohorts. Liver stiffness (LSM) was measured with FibroTouch in all subjects. Simultaneously, color Doppler ultrasound was used to detect the spectrum waveform of blood flow in portal vein, left hepatic vein, middle hepatic vein, and right hepatic vein. M-mode ultrasound was used to measure heart rate. The obtained blood flow spectrum images and heart rate were uploaded to the “Liver Hemodynamics Detection Software” system to calculate the liver blood flow frequency value (LBFF). The liver hardness value measured by FibroTouch and the frequency of liver blood flow measured by PMD were compared with the pathological diagnosis of liver tissue puncture biopsy.Results For the pathological diagnosis of liver tissue of 82 patients with chronic hepatitis B, 33 cases were in stage 1, 22 cases were in stage 2, 10 cases were in stage 3, and 17 cases were in stage 4. The liver hardness values of 114 subjects ranged from 3.7 to 55.1kPa, showing a significant positive correlation with liver fibrosis stages (r=0.811, P<0.01); The frequency of liver blood flow ranged from 0 to 26Hz, which was positively correlated with the stages of liver fibrosis (r=0.831, P<0.01). The cutoff values of LSM≥S1, ≥S2, ≥S3, and=S4 were 6.05, 7.95, 11.2, and 10.35 kPa, respectively, and the AUC were 95.9%, 88.3%, 91.6%, and 90%, respectively; The sensitivities were 89%, 93.9%, 88.9%, and 100%, respectively; The specificities were 100%, 78.5%, 83.9%, and 73.2%, respectively. The cutoff values for LBFF ≥S1, ≥S2, ≥S3, and=S4 were 1.233, 1.99, 3.8, and 5.815 Hz, respectively; The AUC values were 0.899, 0.939, 0.944, and 0.972, respectively. The sensitivities were 78%, 78.8%, 88.9%, and 88.2%, respectively; The specificity were 100%, 83.1%, 83.9%, and 95.9%, respectively.Conclusion FibroTouch and PMD, as non-invasive methods for detecting liver fibrosis, have a good correlation with the pathological stages of liver fibrosis. They can accurately evaluate the degrees of liver fibrosis and can be widely used in clinical practice.

Key words: FibroTouch, Liver hemodynamic software, Color Doppler ultrasound, Portal vein, Hepatic vein, Staging of liver fibrosis