何海峰 1严辉群 1曾志伟 1张瑞芬 1林阿娜 1王伟 2吴纯西3
作者信息
- 1. 325024 浙江省温州市龙湾区第一人民医院超声科
- 2. 310006 浙江省杭州市,浙江省中医院超声科
- 3. 314500 浙江省桐乡市第一人民医院超声科
- 折叠
摘要
Abstract
Objective To investigate the diagnostic value of acoustic radiation force impulse(ARFI) imaging in primary sclerosing cholangitis(PSC).Methods The enrolled participants were all from the First People's Hospital of Longwan District,Wenzhou,including 57 inpatients with PSC who received treatment from December 2014 to October 2016(PSC group,8 cases in stage Ⅰ,20 cases in stage Ⅱ,22 cases in stage Ⅲ and 7 cases in stage Ⅳ) and 59 healthy volunteers without PSC selected from doctors and patients in the same hospital during the same period(control group).The measurement of serum total bilirubin(TBIL),international normalized ratio(INR),aspartate aminotransferase(AST),alanine aminotransferase(ALT),alkaline phosphatase(ALP),γ glutamyl transpeptidase(GGT) and immunoglobulin G(IgG) were performed,platelet ratio index(APRI) score was calculated,Fibrosis-4(FIB-4) score and Mayo risk score were assessed,and shear wave velocity(SWV) of the right hepatic lobe was measured in both groups.ROC analysis was conducted to explore the diagnostic significance of APRI score,FIB-4 score and SWV of the right hepatic lobe for PSC.Results The levels of TBIL,INR,AST,ALT,ALP,GGT,IgG,APRI score,FIB-4 score,Mayo risk score in PSC group were significantly higher than those in the control group(P<0.05).The SWV of the right hepatic lobe for PSC group was faster than that of the control group(P<0.05).The SWV of the stage Ⅳ patients for PSC group was faster than the stage Ⅰ, Ⅱ, Ⅲ patients for PSC group, and the SWV of the stage Ⅲ patients for PSC group was faster than the stage Ⅰ, Ⅱ patients for PSC group(P<0.05). The SWV of the right hepatic lobe was positively correlated with APRI score(r=0.745,P<0.05) and FIB-4 score(r=0.582, P<0.05) in PSC group.For diagnosing PSC,the area under the ROC curve(AUC) of the APRI score,FIB-4 score,and SWV was 0.812,0.740,0.881,respectively;SWV had larger AUC than FIB-4 score(P<0.05).Conclusion ARFI imaging plays a role of clinical guidance by providing accurate diagnosis of PSC as a quantitative tool.关键词
胆管炎,硬化性/超声辐射脉冲成像/剪切波速度Key words
Cholangitis/sclerosing/Acoustic radiation force impulse imaging/Shear wave velocity分类
医药卫生
