The Preliminary Study On The Effect Of Interventional Therapy In Patients With Chronic Hepatitis B By Acoustic Radiation Force Impulse Imaging

Part 1 The diagnostic value of ARFI,APRI index and FIB-4 index on chronic hepatitis B cirrhosis Objective The ARFI,APRI index and FIB-4 index were used to diagnose chronic hepatitis B cirrhosis.Methods A total of 416 patients with chronic hepatitis B who were hospitalized between February 2017 and July 2018 were selected.The ARFI,APRI and FIB-4 index were used to evaluate the degree of hepatic fibrosis.The diagnostic value of ARFI technology,APRI index and FIB-4 index in chronic hepatitis B cirrhosis was analyzed Results ARFI,APRI index and FIB-4 index all showed a positive correlation with the pathological stages(r=0.61,0.25,0.29,respectively)(P<0.0001),and were of certain value in the diagnosis of cirrhosis(AUROC=0.79,0.58 and 0.62,respectively).Conclusion ARFI,APRI and FIB-4 index were correlated with hepatic fibrosis and had certain diagnostic value for liver cirrhosis.Part 2 Comparison between acoustic radiation force impulse imaging and serological model in diagnosing liver fibrosis stageObjective Analyze and compare the diagnostic value between the VTQ value of liver,spleen and serological model on staging liver fibrosis in patients with chronic hepatitis B.Methods A total of 273 patients with chronic viral hepatitis B from February 2017 to January 2018 undergo liver biopsy,acoustic radiation force impulse and blood test.Comparative analysis of diagnostic value between the VTQ value of right anterior section,left hepatic lobe,spleen and APRI index,FIB-4 index on assessment liver fibrosis in patients with CHB according to biopsy.Results The VTQ value of right anterior section,left hepatic lobe,spleen and APRI,FIB-4 index were significantly positively correlated with fibrosis stages(P<0.0001).According to the ROC curves for the diagnosis of significant fibrosis(?F2),severe fibrosis(?F3)and cirrhosis(F4),the VTQ value of right anterior section had better diagnostic value than the VTQ value of left hepatic lobe,the VTQ value of spleen,APRI and FIB-4 index(P<0.0001).Conclusion The VTQ value of right anterior section,left hepatic lobe,spleen and APRI,FIB-4 index have significant value on assessment liver fibrosis in patients with CHB,the VTQ value of right anterior section had better diagnostic value than the others.Part 3 Combination of ARFI and AST/PLT to assess liver fibrosis in patients with chronic hepatitis BObjective To explore the diagnostic value of ARFI combined with AST/PLT on assessment liver fibrosis in patients with chronic hepatitis B(CHB).Methods ARFI,serum analysis and percutaneous liver biopsy guided by ultrasound were performed in 146 patients with CHB.The diagnostic efficacy of ARFI combined with AST/PLT was obtained by taking the results of liver biopsy as the gold standard,and the results were compared with non-invasive diagnostic models,including ARFI and serological diagnostic models(APRI,FIB-4).Results ARFI-AST/PLT,ARFI,APRI and FIB-4 were significantly positively correlated with fibrosis stages(r=0.74,0.69,0.54,0.57,respectively)(P<0.05).Compared with ARFI,APRI and FIB-4,ARFI-AST/PLT had better diagnostic value for significant fibrosis(?F2)and advanced fibrosis(?F3)(P<0.05).ARFI-AST/PLT had better diagnostic value for cirrhosis(F4)than APRI and FIB-4(P<0.05),while there was not significant difference between ARFI-AST/PLT and ARFI(P>0.05).Conclusion Combination of ARFI and AST/PLT had better diagnostic value for significant fibrosis and advanced fibrosis than ARFI,APRI and FIB-4 alone.Part 4 Clinical value of ARFI in assessing the efficacy of intrahepatic injection drug in patients with chronic hepatitis BObjective To evaluate the improvement of liver fibrosis in patients with chronic hepatitis B(CHB)patients after ultrasound-guided interventional therapy by ARFI.Methods 107 CHB patients who received ultrasound-guided interventional therapy were enrolled in the study.ARFI and serological examination were used to measure shear wave velocity(SWV)value,APRI index and FIB-4 index before and after interventional therapy.Analysis SWV value,APRI index and FIB-4 index after different period of treatment.Results The SWV value of liver after 3 period of treatment were significantly lower than before(P<0.05).Conclusion Ultrasound-guided interventional therapy can reduce the degree of liver fibrosis in patients with chronic hepatitis B,and ARFI technology has certain application value in the evaluation of the degree of liver fibrosis in the treatment process.