基于超微血管成像技术的血管指数定量评估肝纤维化程度的应用价值

何亚东; 孙医学; 庞青; 李冬冬; 李阳

doi:10.16766/j.cnki.issn.1674-4152.003084

基于超微血管成像技术的血管指数定量评估肝纤维化程度的应用价值

doi: 10.16766/j.cnki.issn.1674-4152.003084

何亚东^{1, 2},
孙医学^{1, 2},
庞青³,
李冬冬⁴,
李阳^{1, 2, ,}

1.
蚌埠医学院第一附属医院超声科，安徽蚌埠 233004
2.
数字医学与智慧健康安徽普通高校重点实验室(蚌埠医学院)，安徽蚌埠 233030
3.
蚌埠医学院第一附属医院肝胆外科
4.
蚌埠医学院第一附属医院感染科

基金项目:

安徽高校自然科学研究项目 KJ2020A0582

蚌埠医学院厅级重点实验室开放课题基金项目 AHCM2022Z003

蚌埠医学院研究生科研创新计划项目 Byycx22141

详细信息

通讯作者:
李阳，E-mail：onlyworld_2012@126.com

中图分类号: R575.2 R445
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出版历程
- 收稿日期: 2023-03-02
- 网络出版日期: 2023-08-28

Application value of superb microvascular imaging-based vascular index to quantitatively assess liver fibrosis

HE Yadong^{1, 2},
SUN Yixue^{1, 2},
PANG Qing³,
LI Dongdong⁴,
LI Yang^{1, 2
, ,}

1.
Department of Ultrasound, the First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui 233004, China

摘要

摘要: 目的应用基于超微血管成像(SMI)技术的血管指数(SMI-VI)评估肝纤维化患者的新生血管情况，以期找到一种可重复、定量评估肝纤维化程度的新方法。方法使用SMI技术测量2020年9月—2021年8月于蚌埠医学院第一附属医院就诊的93例肝纤维化患者及25名健康人群肝包膜下血管指数，探讨血管指数与肝纤维化级别的关系，并比较轻度肝纤维化患者与健康人群的血管指数差异。绘制血管指数诊断各肝纤维化分期的ROC曲线，确定最佳截断值。结果 SMI-VI与肝纤维化级别呈正相关关系(r=0.754，P＜0.001)。轻度肝纤维化患者SMI-VI为10.40(8.28, 13.63)，高于健康人群[8.60(6.85, 10.10)], 差异有统计学意义(P＜0.05)。SMI-VI诊断显著肝纤维化、进展期肝纤维化、肝硬化的截断值分别为10.65、12.25、14.55，相应的曲线下面积分别为0.86、0.89、0.95，灵敏度分别为88%、86%、85%，特异度分别为70%、72%、90%。结论基于SMI技术的血管指数通过分析肝包膜下的血管数目，可以无创、简便地定量评估肝纤维化程度，具有重要的临床应用价值。
- 超微血管成像 /
- 肝纤维化 /
- 血管指数
Abstract: Objective The Superb microvascular imaging (SMI) -based vascular index (SMI-VI) technique was applied to evaluate neovascularization in patients with hepatic fibrosis, to provide a new repeatable and quantitative assessment of the extent of liver fibrosis. Methods The SMI technique was used to measure the subcapsular vascular index of 93 patients with liver fibrosis and 25 healthy normal subjects who were treated in the First Affiliated Hospital of Bengbu Medical College from September 2020 to August 2021, to investigate the relationship between vascular index and the degree of liver fibrosis, and to compare the difference of the vascular index between patients with mild liver fibrosis and healthy normal subjects. The ROC curve of the vascular index was plotted to determine the optimal cut-off value for each stage of hepatic fibrosis. Results SMI-VI was positively correlated with the level of liver fibrosis (r= 0.754, P < 0.001). SMI-VI in patients with mild liver fibrosis was 10.40 (8.28, 13.63), which was higher than that in healthy normal subjects [8.60 (6.85, 10.10)], and the difference was statistically significant (P < 0.05). The cut-off values of SMI-VI for the diagnosis of significant liver fibrosis, progressive liver fibrosis, and cirrhosis were 10.65, 12.25 and 14.55, with corresponding areas under the curve of 0.86, 0.89 and 0.95, sensitivity of 88%, 86% and 85% and specificity of 70%, 72% and 90%, respectively. Conclusion The vascular index based on SMI technology has important clinical applications as it can quantitatively assess the degree of liver fibrosis non-invasively and easily by analyzing the number of vessels under the liver capsule.
- Superb microvascular imaging /
- Liver fibrosis /
- Vascular index

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图 1 不同程度肝纤维化肝包膜下SMI-VI代表性图像

注：A示正常健康人，VI为4.40%；B示肝纤维化F1期，VI为7.40%；C示肝纤维化F2期，VI为12.50%；D示肝纤维化F3期，VI为16.60%；E示肝纤维化F4期，VI为19.30%。

Figure 1. Representative images of subcapsular SMI-VI in patients with different degrees of hepatic fibrosisRepresentative images of hepatic subcapsular SMA VI in patients with different degrees of hepatic fibrosis

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图 2 不同程度肝纤维化患者肝包膜下血管指数比较

Figure 2. Comparison of hepatic subcapsular vascular index in patients with different degrees of hepatic fibrosis

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图 3 SMI-VI诊断各肝纤维化分期的ROC曲线

Figure 3. The ROC curve of SMI-VI in diagnosing various stages of hepatic fibrosis ROC curves of SMI VI for diagnosis of each stage of hepatic fibrosis

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表 1 93例肝纤维化患者病因及病理分期(例)

Table 1. Etiology and pathological stage of 93 patients with hepatic fibrosis (cases)

病因	例数	F1期(34例)	F2期(17例)	F3期(22例)	F4期(20例)
乙型病毒性肝炎	68	28	10	17	13
自身免疫性肝炎	8	1	5	2	0
丙型病毒性肝炎	10	3	2	1	4
脂肪性肝炎	5	2	0	1	2
药物性肝炎	1	0	0	0	1
血色病	1	0	0	1	0

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