[1]段星星,彭娅,刘凌萍,等. 超声剪切波弹性成像技术对胆道闭锁筛查与诊断的临床价值分析[J].临床小儿外科杂志,2018,17(11):821-825.
　Duan Xingxing,Peng Ya,Liu Lingping,et al. Value of shear wave elastography in differentiating biliary atresia from cholestatic hepatitis in infants.[J].Journal of Clinical Pediatric Surgery,2018,17(11):821-825.
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 超声剪切波弹性成像技术对胆道闭锁筛查与诊断的临床价值分析

《临床小儿外科杂志》[ISSN:1671-6353/CN:43-1380/R] 卷: 第17卷 期数: 2018年11期 页码: 821-825 栏目: 专题讨论 出版日期: 2018-11-20
Title:
 Value of shear wave elastography in differentiating biliary atresia from cholestatic hepatitis in infants.
作者:
 段星星; 彭娅; 刘凌萍; 等.
 湖南省儿童医院超声科
Author(s):
 Duan Xingxing; Peng Ya; Liu Lingping; Zhang Jie; Yang Liu; Chen Wenjuan.
 Department of Ultrasonography,Hunan Childrens Hospital,Changsha 410007,China.
关键词:
 ; 胆道闭锁;  超声检查;  弹性成像;  婴儿
Keywords:
 ; Biliary Atresia;  Ultrasonography;  Elastography;  Infant
文献标志码:
A
摘要:
 目的初步探讨超声剪切波弹性成像（shear wave elastography,SWE）技术对胆道闭锁（biliary atresia,BA）的鉴别诊断价值。方法以2016年11月至2017年12月湖南省儿童医院收治的138例日龄90 d内、疑似胆汁淤积性肝病患儿为研究对象，采用SWE技术对患儿进行肝杨氏模量检测。根据病理诊断结果将所有患儿分为BA组与非BA组，并根据日龄分为≤30 d、31~60 d、61~90 d组。运用受试者操作特性曲线（receiver operating characteristic curve,ROC）得到肝杨氏模量值诊断BA的曲线下面积（area under ROC,AUROC），并计算最佳临界值、敏感性、特异性、阳性预测值、阴性预测值及诊断准确率。结果138例患儿中，BA组51例，非BA组87例。由ROC曲线结果得出肝杨氏模量值鉴别BA与非BA的最佳临界值为12.35 kPa，敏感度为84.3%，特异度为89.7%，阳性预测值为82.7%，阴性预测值为90.7%，正确率为87.7%，AUROC为0.936。以12.35 kPa为最佳临界值，≤30 d组、31~60 d组及61~90 d组在肝杨氏模量取最佳临界值时诊断BA的敏感性分别为65.0%、94.7%、100%，特异性分别为97.9%、89.3%、54.5%。 结论运用SWE技术检测黄疸患儿肝杨氏模量值有助于BA的鉴别诊断，且SWE对日龄30 d以上BA的诊断敏感性更高。
Abstract:
 ObjectiveTo explore the value of shear wave elastography (SWE) in differentiating biliary atresia (BA) from cholestatic hepatitis in infants aged under 90 days.MethodsSWE was employed for detecting hepatic Youngs modulus of 138 infants aged under 90 days with suspected cholestatic hepatitis.They were classified as BA and nonBA groups by surgical or pathological standard.The sensitivity,specificity,positive predictive value,negative predictive value,accuracy of different liver Youngs modulus in the diagnosis of BA were calculated by receiver operating characteristic curve (ROC).ResultsAmong them,51 cases were diagnosed as BA and another 87 cases nonBA.ROC analysis showed a cutoff value of 12.35 kPa for differentiating two groups.The area under ROC (AUROC) curve was 0.936 with the values of sensitivity,specificity,positive predictive value,negative predictive value and accuracy at 84.3%,89.7%,82.7%,90.7% and 87.7% respectively.Using the same cutoff value of 12.35 kPa,the sensitivity for diagnosing BA was 65.0%,94.7% and 100% in ≤30,31-60 and 61-90 day groups and the specificity 97.9%,89.3% and 54.5% respectively.ConclusionMeasuring hepatic stiffness in pediatric patients with jaundice by SWE is helpful to identify BA and SWE may be more sensitive for infants aged ＞30 days than those ≤30 days.

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更新日期/Last Update: 2018-11-23