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中华普通外科学文献(电子版)

中华普通外科学文献(电子版) ›› 2019, Vol. 13 ›› Issue (05) : 398 -401. doi: 10.3877/cma.j.issn.1674-0793.2019.05.015

所属专题： 文献；

论著

声触诊弹性测量与声脉冲辐射力成像检测肝脾硬度的比较研究
王青娟1, 郑剑1,†(), 古日珍1, 姚小虹1, 康斯亮1, 龙乐香1, 周丹1, 王小立2, 郑荣琴2   
  1. 1. 518115　深圳市龙岗区第三人民医院超声科
    2. 510630　广州，中山大学附属第三医院超声科
  • 收稿日期:2019-06-01 出版日期:2019-10-01
  • 通信作者: 郑剑
  • 基金资助:
    深圳市科创委基金资助项目(JCYJ20170307161018414); 广东省科技计划项目(2016A020215 072); 广东省医学科学技术研究基金资助项目(A2016128)

Comparison study of sound touch quantification and acoustic radiation force impulse imaging in measuring liver and spleen stiffness

Qingjuan Wang1, Jian Zheng1,†(), Rizhen Gu1, Xiaohong Yao1, Siliang Kang1, Lexiang Long1, Dan Zhou1, Xiaoli Wang2, Rongqin Zheng2   

  1. 1. Department of Ultrasound, the Third People’s Hospital ofLonggang District, Shenzhen 518115, China
    2. Department of Ultrasound, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China
  • Received:2019-06-01 Published:2019-10-01
  • Corresponding author: Jian Zheng
  • About author:
    Corresponding author: Zheng Jian, Email:
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引用本文：

王青娟, 郑剑, 古日珍, 姚小虹, 康斯亮, 龙乐香, 周丹, 王小立, 郑荣琴. 声触诊弹性测量与声脉冲辐射力成像检测肝脾硬度的比较研究[J/OL]. 中华普通外科学文献(电子版), 2019, 13(05): 398-401.

Qingjuan Wang, Jian Zheng, Rizhen Gu, Xiaohong Yao, Siliang Kang, Lexiang Long, Dan Zhou, Xiaoli Wang, Rongqin Zheng. Comparison study of sound touch quantification and acoustic radiation force impulse imaging in measuring liver and spleen stiffness[J/OL]. Chinese Archives of General Surgery(Electronic Edition), 2019, 13(05): 398-401.

目的

对比研究声触诊弹性测量（STQ）和声脉冲辐射力成像（ARFI）检测肝、脾硬度的可行性。

方法

2018年1月至2019年4月间，采用STQ和ARFI技术对71名健康志愿者、深圳市龙岗区第三人民医院收治的99例慢性乙型肝炎患者行肝、脾硬度检测，对比分析两种检测方法的成功率、变异度、操作者内重复性，并对STQ和ARFI的肝、脾硬度测值进行比较。

结果

肝脏STQ、ARFI检测成功率分别为96.5%（164/170）、95.9%（163/170）（χ2<0.001，P=0.996），变异度分别为（6.48±4.72）%、（8.75±5.01）%（t=4.127，P<0.001）；脾脏STQ、ARFI检测成功率分别为94.7%（161/170）、92.9%（158/170） （χ2=0.215，P=0.643），变异度分别为（7.34±4.26）%、（11.04±4.77）%（t=6.282，P<0.001）。正常肝硬度STQ测值为（1.45±0.18）m/s，显著高于ARFI测值（1.15±0.30）m/s（t=7.565，P<0.001）；慢性乙型肝炎患者肝硬度STQ测值为（1.59±0.26）m/s，显著高于ARFI测值（1.24±0.30）m/s（t=14.005，P<0.001）。正常脾硬度STQ测值为（2.31±0.25） m/s，显著高于ARFI测值（1.96±0.45） m/s （t=5.555，P<0.001）；慢性乙型肝炎患者脾硬度STQ测值为（2.33±0.25） m/s，显著高于ARFI测值（2.08±0.42）m/s（t=5.396，P<0.001）。

结论

STQ和ARFI检测肝、脾硬度成功率较高、检测变异度低；与ARFI相比，STQ进一步提高了测值稳定性。STQ与ARFI的测值不能直接等同，在临床应用中需要注意区分。

关键词: 超声检查, 肝炎，乙型，慢性, 脾, 硬度, 声触诊弹性测量, 声脉冲辐射力成像
Objective

To compare sound touch quantification (STQ) and acoustic radiation force impulse imaging (ARFI) in measuring liver and spleen stiffness.

Methods

From January 2018 to April 2019, using STQ and ARFI technology, a total of one hundred and seventy subjects (71 healthy volunteers and 99 patients with chronic hepatitis B) were tested for liver and spleen stiffness. The success rate, variability and measured values of the two techniques were compared.

Results

The success rate of liver STQ and ARFI was 96.5% (164/170) and 95.9% (163/170) (χ2<0.001, P=0.996), and the variability was (6.48±4.72) %and (8.75±5.01) % (t=4.127, P<0.001), respectively. The success rate of spleen STQ and ARFI was 94.7% (161/170) and 92.9% (158/170) (χ2=0.215, P=0.643), and the variability was (7.34±4.26) % and (11.04±4.77) % (t=6.282, P<0.001), respectively. Normal liver STQ and ARFI values were (1.45±0.18) m/sand (1.15±0.30) m/s (t=7.565, P<0.001), and chronic hepatitis B patients were (1.59±0.26) m/s and (1.24±0.30) m/s (t=14.005, P<0.001). The normal spleen STQ and ARFI values were (2.31±0.25) m/sand (1.96±0.45) m/s (t=5.555, P<0.001), and chronic hepatitis B patients were (2.33±0.25) m/s and (2.08±0.42) m/s (t=5.396, P<0.001), respectively.

Conclusions

The success rate of STQ and ARFI is high and the variability is low. Compared with ARFI, STQ further improves the stability of measurement. In addition, the measured values of STQ and ARFI cannot be directly equivalent, which needs to be distinguished in clinical application.

Key words: Ultrasonography, Hepatitis B, chronic, Spleen, Hardness, Sound touch quantification, Acoustic radiation force impulse imaging
图1 声触诊弹性测量（STQ）检测成功标准　呼吸运动指数≥4颗星为检测成功（A），否则为检测不成功（B）
表1 170名受试者肝脏及脾脏STQ和ARFI检测失败原因分析[例(%)]
检测方法 失败 呼吸配合不好 变异度过大 脾脏体积小
肝STQ 6(3.5) 4(2.4) 2(1.2) -
肝ARFI 7(4.1) 3(1.8) 4(2.4) -
脾STQ 9(5.3) 5(2.9) 0(0) 4(2.4)
脾ARFI 12(7.1) 2(1.2) 7(4.1) 3(1.8)
表2 肝脏及脾脏STQ和ARFI的检测变异度和重复性
检测方法 变异度(%) 操作者内重复性(95%CI) 操作者间重复性(95%CI)
肝脏 脾脏 肝脏 脾脏 肝脏 脾脏
STQ 6.48±4.72 7.34±4.26 0.955(0.943~0.965) 0.907(0.882~0.928) 0.938(0.864~0.972) 0.641(0.212~0.836)
ARFI 8.75±5.01 11.04±4.77 0.941(0.925~0.954) 0.929(0.910~0.946) 0.845(0.673~0.926) 0.543(0.057~0.802)
统计值 t=4.127 t=6.282 Z=1.232 Z=1.227 Z=1.721 Z=0.507
P值 <0.001 <0.001 0.218 0.220 0.085 0.612
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