Preliminary Research Of Velocity Vector Imaging In The Diagnostic Value Of Hepatic Fibrosis

Objectives To observe the passive movement of left liver lobe by heart with VVI. The objective of this research was to select the optimal index for the diagnosis of hepatic fibrosis and analyze the boundary value at different stages of hepatic fibrosis. It was to explore the value of that VVI in diagnosis and stage of hepatic fibrosis.Methods 1 From October 2014 to February 2016,122 patients who had been diagnosed CHB were selected in Affiliated Hospital of North China University of Science and Technology and Infectious Disease Hospital of Tangshan. These patients were divided into five groups(19 patients of S0, 23 of S1, 28 of S2, 26 of S3, 26 of S4) according to the pathology of hepatic fibrosis stages. While 90 healthy people(excluding liver disease)were included as control group in Affiliated Hospital of North China University of Science and Technology. 2 After routine ultrasound scanning was performed on objects of study,the ECG electrodes were connected. Stored the motion pictures of the left liver lobe in the sagittal plane at least three cardiac cycles. To measure the V1 max, V2 max, V3 max, SR1 max,SR2max, SR3 max, SR1 max, SR2 max, SR3 max from the diaphragm 1cm, 2cm, 3cm by VVI software. 3 Database was built in Excel and was analyzed with SPSS 17.0 statistical software. The measurement data were expressed by mean ± standard deviation( sx ±),multiple groups of measurement data were compared using ANOVA. Chi-squared test was used to compare classified variable. The correlation analysis between the stage of hepatic fibrosis and VVI index was conducted with Spearman. Binary Logistic regression was used to analyze the importance of the main index in the diagnosis of hepatic fibrosis. The diagnostic value and the best diagnostic threshold value of independent variable were determined by the ROC curve of different stages of hepatic fibrosis.Results 1 There were no significant difference in gender, age, HR, EF among S0, S1, S2,S3, S4 groups and control group(P>0.05), same to in BMI between the four groups(control group, S0, S1, S2, S3 groups) and S4 group(P<0.05). It showed that the BMI of S4 group was less than control group, S0, S1, S2, S3 groups. 2 The VVI index of different parts from diaphragmatic 1cm, 2cm, 3cm were statistically significant difference(P<0.05).The results indicated that the VVI index gradually decreased as the increase of the distance from the diaphragm, namely V1max>V2max>V3max, S1max>S2max>S3max, SR1max>SR2max>SR3max. 3 There were statistically significant difference in V1 max, V2 max, V3 max, S1 max, S2 max,S3max among S2, S3, S4 groups(P<0.05), indicating that the Vmax and Smax gradually decreased as the progression of hepatic fibrosis. There were statistically significant difference in SR1 max, SR2 max, SR3 max among S1, S2, S3, S4 groups(P<0.05), showing that SRmax could reflect the differences of fibrosis between S1 and S2 groups. The hepatic fibrosis was more severe, the SRmax was smaller. 4 Spearman analysis showed that V1 max,V2max, V3 max, S1 max, S2 max, S3 max, SR1 max, SR2 max, SR3 max negatively correlated with hepatic fibrosis, The more severe hepatic fibrosis, the smaller they were. 5 Binary Logistic regression analysis showed that SR3 max was the most significant variable for the diagnosis of hepatic fibrosis and could better reflect the change of hepatic fibrosis in CHB. Therefore SR3 max could be used as the best diagnostic index. 6 ROC analysis showed that SR3 max had better sensitivity and specificity, and could be used as a index for diagnosis of hepatic fibrosis in different levels.Conclusions 1 The Vmax, Smax, SRmax of all groups are decreased as the increase of the distance from the diaphragm. 2 SRmax in different parts between S1 and S2 groups are significantly different, and S1 group has higher SRmax than S2 group. There are significantly difference in Vmax, Smax, SRmax of different parts among S2, S3, S4 groups, The hepatic fibrosis was more severe, Vmax, Smax, SRmax were smaller. 3 SR3 max has the highest value in diagnosis of hepatic fibrosis. It is the greatest significance while SR3 max are 0.802 s-1, 0.616s-1, 0.445 s-1 in diagnosis of S2, S3, S4 staging hepatic fibrosis. 4 VVI is very important in the diagnosis of hepatic fibrosis.