剪切波弹性成像评估肝移植术后肝脏和脾脏硬度的 临床价值

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Clinical value shear wave elastography in evaluating liver and spleen stiffness after liver transplantation

LIJiaqi，MALe，WANGXu，YANGXi，WANGXinyu，LIGuangsen ，Afiliated，，Chin：

ABSTRACTObjectiveTo investigate clinical value shear wave elastography（SWE）in evaluating liver and spleensiffness inpatientsafterlivertransplantationMethodsAtotal71patientswhounderwentregularlong-terfollwup（ >2 years）after liver transplantation inour hospital were enrolled.Acording to presence splenomegaly before transplantation，yweredivided intogroupA（withoutsplenomegaly，30cases）andgroup B（with splenomegaly，4lcases）. Additionall，35halthyadultswereselectedascontrol group.Allparticipantsunderwenttwo-dimensionalultrasonographyto obtainobliquediameter rightliverlobe，main portalveindiameter，portalvenousflowvelocity，peak systolicvelocity hepatic arteryspleen length，splen thickness，and splenic veindiameter（SVD）.SWE wasperformed toobtain liverand spleenstiffness measurement.Laboratory tests wereconductedtomeasureserumliverfibrosis markers，including hyaluronicacid （HA），lamini（LN），typeII procollagen peptide（PIIP-P），and type IVcollagen（IVC）.Differences inaboveparameters among hegroupswerecompared（LSMandSM）.ThecorrelationbetweenLSMandserumliverfibrosis markers inpatientsafter livertransplantation was analyzed.ResultsThe levelsHA，LN，PIIP N-P，and NC in groups A and B were significantly higher than those in control group，and group B had higherlevels than group A，with statisticaldiferences（all P <0.05）.SVD， spleen length，andspleenthickness ingroup B were significantly higherthan those in control groupand groupA（all P<0.05 ）. LSMin groups AandBwassignificantlyhigher thanthat in controlgroup，andLSMingroupBwassignificantly higherthan that in group A.SSM in group B was significantly higher than that in control group and group A（all P <0.05）.In patients after livertransplantation，SwaspositivelorrlatedwithHA，LN，PIIP-，ndIVC（r0.63，.620.1，.578，all.）. ConclusionSWEcanaurately evaluate transplanted liverandspleen stifnesinpatientsafterliver transplantationand has certain clinical value in monitoring post-transplantliver fibrosis. KEY WORDSShear wave elastography;Liver transplantation;Liver stiffess;Spleen stiffness;Liver fibrosis

慢性肝病目前依然是困扰全世界的公共卫生难题，肝移植是终末期肝病患者最有效的治疗方法[1]。（剩余8296字）