Hepatic and portal vein Doppler ultrasounds in assessing liver inflammation and fibrosis in chronic HBV infection with a normal ALT level.
Hepatic and portal vein Doppler ultrasounds in assessing liver inflammation and fibrosis in chronic HBV infection with a normal ALT level.
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DOI：
10.3389/fmed.2023.1178944
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发表时间：
2023
影响因子：
3.9
通讯作者：
中科院分区：
文献类型：
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目的探讨肝脏及门静脉多普勒超声在慢性乙型肝炎病毒（HBV）感染及谷丙转氨酶（ALT）水平正常患者肝脏炎症及纤维化评估中的临床价值。采用超声引导下行肝活检的慢性HBV感染患者94例，按肝组织病理结果分组。分析肝、门静脉多普勒超声参数在不同程度的肝脏炎症和纤维化中的差异及相关性。27例患者无明显肝损害，67例患者有明显肝损害，两者肝脏及门静脉多普勒超声参数差异有统计学意义（p < 0.05）。随着肝脏炎症的加重，门静脉内径增大，门静脉及肠系膜上静脉血流速度降低（p < 0.05）。肝纤维化加重时，门静脉内径增大，门静脉、肠系膜上静脉、脾静脉血流速度减慢，肝静脉多普勒波形呈单向或平坦化（p < 0.05）。受试者工作特征（ROC）曲线显示，肝脏和门静脉多普勒超声对肝纤维化的评估效果优于单独使用腹部多普勒超声，两种检查技术的结合优于任何单独使用的技术。肝脏和门静脉多普勒超声对慢性HBV感染患者肝纤维化的评估具有重要的临床价值，有助于提高肝纤维化的诊断。
To discuss the clinical value of hepatic and portal vein Doppler ultrasounds in assessing liver inflammation and fibrosis in patients with chronic hepatitis B virus (HBV) infection, and a normal alanine transaminase (ALT) level. 94 patients with chronic HBV infections who had undergone ultrasound-guided liver biopsies were enrolled and grouped by the liver tissue pathological results. Analyzed the differences and correlation between parameters of the hepatic and portal vein Doppler ultrasounds are discussed across different degrees of liver inflammation and fibrosis. There were 27 patients with no significant liver damage and 67 patients with significant liver damage, there were significant differences in the parameters of the hepatic and portal vein Doppler ultrasounds between them (p < 0.05). As liver inflammation was aggravated, the inner diameter of the portal vein increased, and the blood flow velocities of the portal and superior mesenteric veins decreased (p < 0.05). When liver fibrosis became more severe, the inner diameter of the portal vein increased, while the blood flow velocities of the portal, superior mesenteric, and splenic veins decreased, and the Doppler waveforms of hepatic veins became unidirectional or flat (p < 0.05). The receiver operating characteristic (ROC) curve showed the assessment efficacy of hepatic and portal vein Doppler ultrasounds was superior to abdominal Doppler ultrasound alone in assessing liver fibrosis, and the combination of the two examination techniques outperformed any technique used alone. The hepatic and portal vein Doppler ultrasounds have important clinical value for assessing liver fibrosis in patients with chronic HBV infection, to aid improve the diagnosis of liver fibrosis.