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目的初步探讨速度向量成像技术在脂肪肝弹性评价中的应用价值。方法选择轻度、中度、重度脂肪肝患者共69例,正常对照组30例,常规超声扫查后,连接心电电极,存储肝左叶至少3个心动周期动态图像,启动自带VVI软件测量同一直线上距离膈肌1、2、3、4cm处肝组织舒张期运动最大速度(Vmax),最大应变(Smax)及最大应变率(SRmax)。结合脂肪肝超声分度标准对其参数进行分析。结果脂肪肝组与对照组肝左叶舒张期Vmax、Smax及SRmax随着距膈肌距离的增加逐渐减小;对照组与轻度脂肪肝亚组之间Vmax、Smax差异无统计学意义(P>0.05),SRmax差异具有统计学意义(P<0.05);脂肪肝轻、中、重各组之间Vmax、Smax、SRmax差异具有统计学意义(P<0.05),且随着程度加重而减小。通过ROC曲线分析,肝左叶SR4max取值为0.703(s-1)时,判断轻度脂肪肝的灵敏度为93.3%,特异度为82.6%;S1max取值为10.994(%)时,判断中度脂肪肝的灵敏度为95.7%,特异度为84.6%;V4max取值为0.352(10-2cm/s)时,判断重度脂肪肝的灵敏度为92.3%,特异度为90.0%。结论速度向量成像技术在评价脂肪肝弹性变化中具有独特的优势,对脂肪肝的定量诊断具有一定指导意义。
Objective To explore the value of velocity vector imaging in the evaluation of fatty liver. Methods A total of 69 patients with mild, moderate and severe fatty liver were selected. Thirty patients in the control group received routine ultrasonography. Electrocardiographic electrodes were connected to store at least 3 cardiac dynamic images in the left lobe of liver. The maximal diastolic velocity (Vmax), maximum strain (Smax) and maximum strain rate (SRmax) were measured on the same straight line at 1, 2, 3 and 4 cm from the diaphragm. Combined with the standard of fatty liver ultrasound index its parameters were analyzed. Results Vmax, Smax and SRmax in left hepatic lobe of fatty liver group and control group decreased gradually with distance from diaphragmatic muscle. There was no significant difference in Vmax and Smax between control group and mild fatty liver subgroup (P> 0.05). The difference of SRmax was statistically significant (P <0.05). The difference of Vmax, Smax and SRmax between the groups of light, medium and heavy fatty liver was statistically significant (P <0.05), and decreased with the degree of increase . By ROC curve analysis, the sensitivity of mild fatty liver was 93.3% and the specificity was 82.6% when SR4max value of left lobe of liver was 0.703 (s-1). When S1max value was 10.994 (%), the sensitivity The sensitivity and specificity of fatty liver were 95.7% and 84.6%, respectively. The sensitivity and specificity of severe fatty liver were 92.3% and 90.0% respectively when V4max was 0.352 (10-2cm / s). Conclusions Velocity vector imaging has unique advantages in evaluating the elastic changes of fatty liver and has certain guiding significance for the quantitative diagnosis of fatty liver.