实时超声弹性成像技术诊疗梗阻性黄疸的应用价值研究

Application of real time ultrasound elastography in diagnosis and treatment of obstructive jaundice

摘要:

  摘要 目的  探讨实时超声弹性成像技术在诊断梗阻性黄疸及减黄治疗效果评价中的价值。方法  选取2015年1月-2016年6月在浙江省绍兴市人民医院轻度梗阻性黄疸患者40例作为轻度黄疸组，中度梗阻性黄疸患者40例作为中度黄疸组，重度梗阻性黄疸患者40例作为重度黄疸组，同期住院的无黄疸患者40例作为对照组。所有患者进行实时超声弹性成像检查。结果  梗阻性黄疸患者的实时超声弹性成像中颜色分布出现不均匀性，蓝色分布随黄疸程度的加重而增多，绿色分布随着黄疸程度的加重而相对减少；黄疸组总胆红素水平、蓝色领域百分比高于对照组（P <0.05），黄疸组应变均值低于对照组（P <0.05）；重度黄疸组总胆红素水平和蓝色领域百分比高于中度黄疸组和轻度黄疸组（P <0.05），中度黄疸组总胆红素水平和蓝色领域百分比高于轻度黄疸组（P <0.05），重度黄疸组应变均值低于中度黄疸组和轻度黄疸组（P <0.05），中度黄疸组应变均值低于轻度黄疸组（P <0.05）；梗阻性黄疸患者实时超声弹性成像的蓝色领域百分比与总胆红素水平呈正相关（P <0.05），应变均值与总胆红素水平呈负相关（P <0.05）；减黄治疗后总胆红素水平、蓝色领域百分比均低于治疗前（P <0.05），减黄治疗后应变均值高于治疗前（P <0.05）。结论  实时超声弹性成像技术在梗阻性黄疸的诊断、严重程度评估及减黄治疗效果评价中具有一定价值。

Abstract:

Abstract: Objective To explore the value of real-time ultrasound elastography in the diagnosis and treatment of obstructive jaundice. Methods In this study, 40 patients with mild obstructive jaundice were collected as mild jaundice group, 40 patients with moderate obstructive jaundice as moderate jaundice group, 40 patients with severe obstructive jaundice as severe jaundice group, and 40 patients without jaundice as control group from Shaoxing People's Hospital between January 2015 and June 2016. All patients underwent real-time ultrasound elastography. Results In the patients with obstructive jaundice, real-time ultrasound elastography showed that the color distribution was uneven, the blue distribution increased with the increase of degree of jaundice, the green distribution decreased with the increased degree of jaundice. The level of total bilirubin and the percentage of blue areas in the jaundice group were higher than those in the control group (P < 0.05). The mean strain of the jaundice group was lower than that of the control group (P < 0.05). The level of total bilirubin and the percentage of blue areas in the severe jaundice group were higher than those in the moderate jaundice group and the mild jaundice group (P < 0.05). The level of total bilirubin and the percen-tage of blue areas in the moderate jaundice group were higher than those of the mild jaundice group (P <0.05). The mean strain of the severe jaundice group was lower than that of the moderate jaundice group and the mild jaundice group (P < 0.05). The mean strain of the moderate jaundice group was lower than that of the mild jaundice group (P < 0.05). In the patients with obstructive jaundice, the percentage of blue areas in the real-time ultrasound elastogram was positively correlated with total bilirubin level (P < 0.05), the mean strain was negatively correlated with total bilirubin (P < 0.05), and the total bilirubin level and the percentage of blue areas after treatment were significantly lower than those before treatment (P < 0.05). The mean value of strain after treatment was significantly higher than that before treatment (P < 0.05). Conclusions Real-time ultrasound elastography is valuable in the diagnosis, evaluation of severity of obstructive jaundice and therapeutic effect.