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目的:探讨二维剪切波弹性成像(2D-SWE)联合超声造影(CEUS)对老年乙型病毒性肝炎(以下简称乙肝)患者肝纤维化程度的评估价值。方法:抽取2019年7月至2020年8月许昌市人民医院收治的89例老年乙肝患者为研究对象。患者入院时均行2D-SWE与CEUS检查并记录相关参数[剪切波速度(SWV)、弹性模量、肝静脉到达时间(HVAT)、肝动脉-肝静脉渡越时间(HV-HAAT)]，并以肝穿刺活组织检查结果为依据，判断肝纤维化程度并分组。分析2D-SWE联合CEUS在老年乙肝患者肝纤维化程度评估中的应用价值。结果:肝穿刺活检结果显示，89例老年乙肝患者肝纤维化轻度29例，中度38例，重度22例。重度组SWV、弹性模量为(2.16±0.24)m/s和(16.51±1.76)kPa，高于中度组的(1.67±0.18)m/s、(9.47±0.98)kPa，n P<0.05；重度组HVAT、HV-HAAT少于中度组(n P<0.05)。中度组SWV、弹性模量高于轻度组的(1.20±0.12)m/s、(5.80±0.59)kPa，n P<0.05；中度组HVAT、HV-HAAT少于轻度组(n P<0.05)。绘制受试者工作特征曲线结果显示，SWV、弹性模量、HVAT、HV-HAAT单独及联合评估老年乙肝患者肝纤维化程度的曲线下面积分别为0.738、0.720、0.729、0.801、0.826。n 结论:2D-SWE联合CEUS在老年乙肝患者肝纤维化程度评估中的应用价值较高。“,”Objective:To investigate the evaluation value of two-dimensional shear wave elastography (2D-SWE) combined with contrast-enhanced ultrasound (CEUS) on liver fibrosis in elderly patients with hepatitis B.Methods:A total of 89 elderly patients with hepatitis B treated in Xuchang People’s Hospital from July 2019 to August 2020 were selected. All selected patients were examined by 2D-SWE and CEUS. And the related parameters were recorded, sush as shear wave velocity (SWV), elastic modulus, hepatic vein arrival time (HVAT), hepatic artery hepatic vein transit time (HV-HAAT). Based on the results of liver biopsy, the degree of liver fibrosis in patients was judged and grouped. And the application value of 2D-SWE combined with CEUS in the assessment of the degree of liver fibrosis in elderly patients with hepatitis B was analyzed.Results:The results of liver biopsy showed that among the 89 elderly patients with hepatitis B, 29 cases were mild, 38 cases were moderate, and 22 cases were severe. The SWV and elastic modulus of the severe group were (2.16±0.24)m/s and (16.51±1.76)kPa, respectively, which were higher than (1.67±0.18)m/s and (9.47±0.98)kPa of the moderate group (n P<0.05); the HVAT and HV-HAAT of the severe group were shorter than those of the moderate group (n P<0.05). The SWV and elastic modulus of the moderate group were higher than (1.20±0.12)m/s and (5.80±0.59)kPa of the mild group (n P<0.05); the HVAT and HV-HAAT of the moderate group were shorter than those of the mild group (n P<0.05). The receiver operating characteristic curve was drawn, and the area under the curve (AUC) of SWV, elastic modulus, HVAT, HV-HAAT, and combination of these indexes to evaluate the degree of liver fibrosis in elderly patients with hepatitis B was calculated, AUC=0.738, 0.720, 0.729, 0.801, 0.826.n Conclusions:2D-SWE combined with CEUS has high application value in the evaluation of liver fibrosis degree in elderly patients with hepatitis B.