切换至 "中华医学电子期刊资源库"

中华肝脏外科手术学电子杂志 ›› 2019, Vol. 08 ›› Issue (04) : 366 -369. doi: 10.3877/cma.j.issn.2095-3232.2019.04.020

所属专题: 文献

临床研究

声触诊弹性成像和声触诊弹性测量检测肝脾硬度重复性研究
郑剑1, 吴曼丽2, 张敏1, 裴少华1, 王青娟1, 黄晶1, 朱利容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:2019-06-18 出版日期:2019-08-10
  • 通信作者: 郑荣琴
  • 基金资助:
    广东省科技计划项目(2016A020215072); 广东省医学科学技术研究基金(A2016128); 深圳市科创委基金(JCYJ20170307161018414)

Repeatability of sound touch elastography and sound touch quantification in measuring liver and spleen stiffness

Jian Zheng1, Manli Wu2, Min Zhang1, Shaohua Pei1, Qingjuan Wang1, Jing Huang1, Lirong Zhu1, Xiaoli Wang2, Rongqin Zheng2,()   

  1. 1. Department of Ultrasound, the Third People's Hospital of Shenzhen, Shenzhen 518115, China
    2. Department of Ultrasound, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China
  • Received:2019-06-18 Published:2019-08-10
  • Corresponding author: Rongqin Zheng
  • About author:
    Corresponding author: Zheng Rongqin, Email:
引用本文:

郑剑, 吴曼丽, 张敏, 裴少华, 王青娟, 黄晶, 朱利容, 王小立, 郑荣琴. 声触诊弹性成像和声触诊弹性测量检测肝脾硬度重复性研究[J/OL]. 中华肝脏外科手术学电子杂志, 2019, 08(04): 366-369.

Jian Zheng, Manli Wu, Min Zhang, Shaohua Pei, Qingjuan Wang, Jing Huang, Lirong Zhu, Xiaoli Wang, Rongqin Zheng. Repeatability of sound touch elastography and sound touch quantification in measuring liver and spleen stiffness[J/OL]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2019, 08(04): 366-369.

目的

探讨声触诊弹性成像(STE)和声触诊弹性测量(STQ)检测肝、脾硬度的可重复性。

方法

选取2017年10月至2018年6月在深圳市龙岗区第三人民医院行超声检查的245例患者。患者均签署知情同意书,符合医学伦理学规定。其中男157例,女88例;年龄18~80岁,中位年龄37岁。选用两位弹性成像初学者,其中1位无超声检查经验,1位有超声检查经验,分别行肝脏、脾脏STE和STQ检查。采用组内相关系数(ICC)评价检测可重复性,比较采用Z检验。

结果

无超声经验、有超声经验初学者操作50例肝脏STE和STQ检查后ICC分别为0.912、0.971和0.922、0.963,明显高于前50例的0.667、0.825和0.698、0.834(Z=3.558,4.543和3.582,3.803;P<0.05)。对于脾脏STE和STQ,亦有类似的结果(Z=3.582,3.803和2.055,2.162;P<0.05)。操作50例后肝脏STE和STQ两位操作间ICC为0.883和0.896;脾脏STE和STQ相应为0.593和0.517。

结论

对于无论有无超声检查经验的弹性成像初学者,操作50例后可重复性明显提高,肝脏检测可重复性非常好,而脾脏可重复性有待提高。

Objective

To explore the repeatability of sound touch elastography (STE) and sound touch quantification (STQ) in detecting liver and spleen stiffness.

Methods

A total of 245 patients who underwent ultrasound examination in the Third People's Hospital of Shenzhen from October 2017 to June 2018 were recruited in this investigation. The informed consents of all patients were obtained and the local ethical committee approval was received. Among them, 157 patients were male and 88 female. The patients were aged from 18 to 80 years with a median age was 37 years. Two beginners were selected to perform STE and STQ of the liver and spleen. One of them had no ultrasound examination experience and the other had ultrasound examination experience. The repeatability of STE and STQ were assessed by interclass correlation coefficient (ICC) and statistically compared by Z test.

Results

The ICC of liver STE after examining 50 patientsby the beginner without ultrasound experience and the beginner with ultrasound experience were 0.912, 0.971 and the STQ were 0.922, 0.963 , respectively, significantly higher than 0.667, 0.825 and 0.698, 0.834 in the first 50 patients (Z=3.558, 4.543 and 3.582, 3.803; P<0.05). Similar results were obtained for the STE and STQ of spleen (Z=3.582, 3.803 and 2.055, 2.162; P<0.05). The ICC of STE and STQ of liver between two beginners were 0.883 and 0.896 after examination of 50 cases, and were 0.593 and 0.517 for spleen STE and STQ.

Conclusions

For the beginners of elastography with or without ultrasound examination experience, the repeatability of STE and STQ can be significantly improved after 50 cases' examination. The repeatability of liver STE and STQ is extremely high, whereas that of STE and STQ of spleen should be improved.

图1 STE技术测量肝脏硬度的操作者间一致性Bland-Altman散点图
图2 STQ技术测量肝脏硬度的操作者间一致性Bland-Altman散点图
[1]
李俊来,史宪全,曹晓林,等.乳腺浸润性导管癌剪切波弹性模量的病理研究[J/CD].中华医学超声杂志(电子版),2018, 15(5): 374-378.
[2]
Sun JW, Wang XL, Zhao Q, et al. Virtual touch tissue imaging and quantification (VTIQ) in the evaluation of breast lesions: the associated factors leading to misdiagnosis[J]. Eur J Radiol, 2019, 110: 97-104.
[3]
纪欢,张蕾,李守强,等.剪切波弹性成像联合超微血管显像在甲状腺肿块良恶性鉴别诊断中的应用[J].中华超声影像学杂志,2018, 27(2): 143-146.
[4]
Chang W, Tang L, Lu C, et al. Shear wave elastography in the evaluation of level VI lymph nodes in papillary thyroid carcinoma: combined with gray-scale ultrasound ex vivo[J]. BMC Cancer, 2018, 18(1): 1001.
[5]
Zeng J, Zheng J, Jin JY, et al. Shear wave elastography for liver fibrosis in chronic hepatitis B: adapting the cut-offs to alanine aminotransferase levels improves accuracy[J]. Eur Radiol, 2019, 29(2): 857-865.
[6]
金洁玚,郑玉宝,郑剑,等.实时二维剪切波弹性成像评估慢加急性肝衰竭患者的预后[J].中山大学学报(医学科学版),2017, 38(5): 774-779.
[7]
Suh CH, Kim KW, Park SH, et al. Shear wave elastography asa quantitative biomarker of clinically significant portal hypertension: a systematic review and meta-analysis[J]. AJR Am J Roentgenol, 2018, 210(5): W185-195.
[8]
Jansen C, Möller P, Meyer C, et al. Increase in liver stiffness after transjugular intrahepatic portosystemic shunt is associated with inflammation and predicts mortality[J]. Hepatology, 2018, 67(4): 1472-1484.
[9]
郑剑,曾婕,郑荣琴,等.二维剪切波弹性成像、瞬时弹性成像、实时组织弹性成像诊断肝纤维化的效能比较[J/CD].中华医学超声杂志(电子版),2016, 13(7): 496-500.
[10]
Zhang L, Xu J, Wu H, et al. Screening breast lesions using shear modulus and its 1-mm shell in sound touch elastography[J]. Ultrasound Med Biol, 2019, 45(3): 710-719.
[11]
陈征,朱家安.弹性成像在肌骨超声中的应用进展[J].现代实用医学,2017, 29(11): 1405-1408.
[12]
中华医学会超声医学分会介入超声学组弹性成像评估肝纤维化专家组.二维剪切波弹性成像评估慢性乙型肝炎肝纤维化临床应用指南[J].中华超声影像学杂志,2017, 26(11): 921-927.
[13]
Moga TV, Stepan AM, Pienar C, et al. Intra- and inter-observer reproducibility of a 2-D shear wave elastography technique and the impact of ultrasound experience in achieving reliable data[J]. Ultrasound Med Biol, 2018, 44(8): 1627-1637.
[14]
Bamber J, Cosgrove D, Dietrich CF, et al. EFSUMB guidelines and recommendations on the clinical use of ultrasound elastography.part 1: basic principles and technology[J]. Ultraschall Med, 2013, 34(2): 169-184.
[15]
Barr RG, Ferraioli G, Palmeri ML, et al. Elastography assessment of liver fibrosis: society of radiologists in ultrasound consensus conference statement[J]. Radiology, 2015, 276(3): 845-861.
[16]
Shiina T, Nightingale KR, Palmeri ML, et al. WFUMB guidelines and recommendations for clinical use of ultrasound elastography: part 1: basic principles and terminology[J]. Ultrasound Med Biol, 2015, 41(5): 1126-1147.
[17]
Zheng J, Guo H, Zeng J, et al. Two-dimensional shear-wave elastography and conventional US: the optimal evaluation of liver fibrosis and cirrhosis[J]. Radiology, 2015, 275(1): 290-300.
[18]
Jin JY, Zheng YB, Zheng J, et al. 2D shear wave elastography combined with MELD improved prognostic accuracy in patients with acute-on-chronic hepatitis B liver failure[J]. Eur Radiol, 2018, 28(10): 4465-4474.
[19]
深圳迈瑞生物医疗电子股份有限公司.STE弹性成像超声弹性成像的全新解决方案[J].中国超声医学杂志,2017, 33(5): 后插2,封3.
[20]
Balakrishnan M, Souza F, Muñoz C, et al. Liver and spleen stiffness measurements by point shear wave elastography via acoustic radiation force impulse: intraobserver and interobserver variability and predictors of variability in a US population[J]. J Ultrasound Med, 2016, 35(11): 2373-2380.
[1] 章建全, 程杰, 陈红琼, 闫磊. 采用ACR-TIRADS评估甲状腺消融区的调查研究[J/OL]. 中华医学超声杂志(电子版), 2024, 21(10): 966-971.
[2] 罗辉, 方晔. 品管圈在提高甲状腺结节细针穿刺检出率中的应用[J/OL]. 中华医学超声杂志(电子版), 2024, 21(10): 972-977.
[3] 杨忠, 时敬业, 邓学东, 姜纬, 殷林亮, 潘琦, 梁泓, 马建芳, 王珍奇, 张俊, 董姗姗. 产前超声在胎儿22q11.2 微缺失综合征中的应用价值[J/OL]. 中华医学超声杂志(电子版), 2024, 21(09): 852-858.
[4] 孙佳丽, 金琳, 沈崔琴, 陈晴晴, 林艳萍, 李朝军, 徐栋. 机器人辅助超声引导下经皮穿刺的体外实验研究[J/OL]. 中华医学超声杂志(电子版), 2024, 21(09): 884-889.
[5] 史学兵, 谢迎东, 谢霓, 徐超丽, 杨斌, 孙帼. 声辐射力弹性成像对不可切除肝细胞癌门静脉癌栓患者放射治疗效果的评价[J/OL]. 中华医学超声杂志(电子版), 2024, 21(08): 778-784.
[6] 李洋, 蔡金玉, 党晓智, 常婉英, 巨艳, 高毅, 宋宏萍. 基于深度学习的乳腺超声应变弹性图像生成模型的应用研究[J/OL]. 中华医学超声杂志(电子版), 2024, 21(06): 563-570.
[7] 洪玮, 叶细容, 刘枝红, 杨银凤, 吕志红. 超声影像组学联合临床病理特征预测乳腺癌新辅助化疗完全病理缓解的价值[J/OL]. 中华医学超声杂志(电子版), 2024, 21(06): 571-579.
[8] 项文静, 徐燕, 茹彤, 郑明明, 顾燕, 戴晨燕, 朱湘玉, 严陈晨. 神经学超声检查在产前诊断胼胝体异常中的应用价值[J/OL]. 中华医学超声杂志(电子版), 2024, 21(05): 470-476.
[9] 胡可, 鲁蓉. 基于多参数超声特征的中老年女性压力性尿失禁诊断模型研究[J/OL]. 中华医学超声杂志(电子版), 2024, 21(05): 477-483.
[10] 唐小清, 何萍, 杨友, 罗霞, 张菊英, 杨鑫, 余进洪. 声触诊弹性成像联合脉冲多普勒超声成像参数与早期慢性肾脏病分期的相关性及临床价值[J/OL]. 中华医学超声杂志(电子版), 2024, 21(05): 491-499.
[11] 张妍, 原韶玲, 史泽洪, 郭馨阳, 牛菁华. 小肾肿瘤超声漏诊原因分析新思路[J/OL]. 中华医学超声杂志(电子版), 2024, 21(05): 500-504.
[12] 席芬, 张培培, 孝梦甦, 刘真真, 张一休, 张璟, 朱庆莉, 孟华. 乳腺错构瘤的临床与超声影像学特征分析[J/OL]. 中华医学超声杂志(电子版), 2024, 21(05): 505-510.
[13] 钱警语, 郑明明. 《2024意大利妇产科学会非侵入性和侵入性产前诊断指南》解读[J/OL]. 中华妇幼临床医学杂志(电子版), 2024, 20(05): 486-492.
[14] 张琛, 秦鸣, 董娟, 陈玉龙. 超声检查对儿童肠扭转缺血性改变的诊断价值[J/OL]. 中华消化病与影像杂志(电子版), 2024, 14(06): 565-568.
[15] 陈秀晓, 隋文倩, 王珉鑫, 吴圆圆. 腹股沟斜疝并腹腔游离体超声表现一例[J/OL]. 中华临床医师杂志(电子版), 2024, 18(05): 516-517.
阅读次数
全文


摘要