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目的:探讨肝细胞脂肪变性对肝脏弥散度成像技术(Realtime Tissue Elastography,RTE)无创评估病毒性肝炎肝纤维化及炎症程度的影响。方法:91例确诊慢性乙型或丙型病毒性肝炎患者均于肝脏活检穿刺前行肝脏弥散度成像检查,分析不同肝细胞脂肪变性程度与肝纤维化程度及肝脏炎症程度之间的弥散度成像LF指数差异。结果:中度脂肪变性组LF指数最高(P=0.0254);轻度纤维化(S1-S2)时,不同的脂肪变性程度组间LF值的差异无统计学意义(P=0.1105);中-重度纤维化时,不同的脂肪变性程度组间LF值的差异无统计学意义(P=0.0994)。轻度炎症时,不同的脂肪变性程度组间LF值的差异具有统计学意义,中度脂肪变性组的LF值最高(P=0.0010);中-重度炎症时,不同的脂肪变性程度组间LF值的差异具有统计学意义(P<0.05)。结论:应用肝脏弥散度成像的LF指数判断肝脏纤维化程度不受肝细胞脂肪变性的影响,但对于肝脏炎症程度的判断受肝细胞脂肪变性的影响,尤其应重视中度肝细胞脂肪变性对于测值的影响。
Objective: To investigate the effect of hepatic steatosis on the noninvasive assessment of hepatic fibrosis and inflammation in viral hepatitis by Realtime Tissue Elastography (RTE). Methods: 91 patients diagnosed with chronic hepatitis B or C were examined with liver diffuse imaging before liver biopsy, and the degree of hepatic steatosis and hepatic fibrosis were analyzed with diffusion imaging LF index difference. Results: The LF index was the highest in moderate steatosis group (P = 0.0254), while there was no significant difference in LF value between mild steatosis group and mild steatosis group (P = 0.1105) In severe fibrosis, there was no significant difference in LF values among different degrees of steatosis (P = 0.0994). In mild inflammation, there were significant differences in LF values among different degrees of steatosis, with the highest LF in moderate steatosis (P = 0.0010). In moderate-severe inflammation, different degrees of steatosis between groups LF The difference was statistically significant (P <0.05). Conclusions: The degree of liver fibrosis is not affected by hepatic steatosis using the LF index of hepatic diffusion imaging. However, the degree of hepatic inflammation is affected by the steatosis of hepatocytes. In particular, moderate hepatic steatosis should be considered for the measurement Impact.