Evaluation of hepatic fibrosis status of patients with obstructive jaundice before and after PTCD by means of ultrasonic elastography quantitative analysis

doi:10.3969/j.issn.1002-7386.2017.13.001

Abstract：Objective To use ultrasonic elastography quantitative analysis to evaluate the hepatic fibrosis status of patients with obstructive jaundice before and after percutaneous transhepaticcholangial drainage (PTCD) .Methods Ninety-eight patients with obstructive jaundice who would receive PTCD therapy were enrolled in the study.The laboratory indexes detection,multi-indexes of ultrasonic elastography quantitative analysis and one-factor analysis of variance were performed to find sensitive indexes of hepatic function.The patients were divided into hepatic fibrosis group (n=19) and non-hepatic fibrosis group (n=19).The changes of levels of ALT,AST,TBiL,MEAN,AREA% were observed and compared between two groups.The subjects operator characteristic (ROC) curves were used to evaluate the area under curve (AUC) of hepatic fibrosis,best critical value,sensitivity and specificity.Results As compared with those before PTCD,the levels of ALT,AST,TBiL and MEAN,AREA% on 1 week after PTCD were significantly increased (P<0.05).The diagnosis levels (MEAN,AREA%) of ultrasonic elastography quantitative analysis after PTCD in diagnosis of hepatic fibrosis were significantly high than those by laboratory hepatic fibrosis sensitive indexes (ALT,AST,TBiL).The AUC of ROC curve of MEAN was 0.890,taking 109.83 as best critical value,sensitivity was 80.4% and specificity was 95.2%.The AUC of ROC curve of AREA% was 0.889,taking 24.48 as best critical value,sensitivity was 66.1% and specificity was 100%.The AUC of ROC curve by combination diagnosis of MEAN and ALT was 0.962,taking 0.57 as best critical value,sensitivity was 83.9% and specificity was 99.52%,and both were higher than those by single index diagnosis.Conclusion The ultrasonic elastography quantitative analysis is superior to laboratory sensitive indexes in diagnosis of hepatic fibrosis to evaluate the hepatic fibrosis status of patients with obstructive jaundice before PTCD,moreover,combination diagnosis of both methods can enhance diagnostic accuracy of liver fibrosis.