瞬时弹性成像技术检测肝硬度失败原因及对策

瞬时弹性成像技术检测肝硬度失败原因及对策

摘要：目的探讨瞬时弹性成像技术（FibroScan）测量肝硬度失败原因及提高成

功率的方法。方法用FibroScan 对5000 例慢性肝病患者进行肝脏硬度检测，每例进行10次有效测量，并对检测失败的患者进行身高、体重、肋间隙宽度测量、

肝脏B 超或CT检查，以评价身体质量指数、性别、年龄、肋间隙、影像原因对

检测成功的影响.结果 5000例检测者中的240例检测失败，失败率为4.8%。

BMI≥28kg /m2 者失败率明显高于BMI ＜ 28kg /m2 者（，女性失败率高于男性，

老年人失败率较<60 岁的人高，肋间隙＜ 9mm 患者失败率高，差异均有统计学意

义（P<0.01）.肝脏影像学显示异常（肝脏血管瘤、结节、囊肿，肝脏缩小、腹腔

积液、气体干扰）患者检测失败173例，失败率为3.5%。对240 例初次检测失败

患者采取重新摆放体位、更换检测部位、调整探头方向等方法重新检测成功52

例，使失败率降低至3.8%。结论FibroScan 检测的失败多由于肥胖、肋间隙狭窄、肝脏影像学显示异常（肝脏血管瘤、结节、囊肿，肝脏缩小、腹腔积液、气体干

扰等）引起，老年人与女性检测失败率较高。针对检测失败的原因，采取相应的

对策，可降低检测失败率。

关键词：瞬时弹性成像技术；肝硬度检测；失败率

Abstract Objective To investigate the cause of the failure of the transient elastic imaging（FibroScan）and the method of improving the success rate.Methods 5000 cases were detected for liver stiffness with FibroScan，

in each case were 10 times of the effective measurement，and in patients with failure detection for height，weight，rib clearance width measurement，liver B ultrasonic

or CT examination and evaluation of body mass index，gender，age，intercostal space，image of the successful detection of influence.Results LSM failure occurred in 4.8% of all examinations（240 patients out of 5000）.Body mass index（BMI）≥28kg /m2 failure rate was significantly higher than BMI ＜28kg /m2.The failure rate of female patients with liver stiffness was higher than that of male，the elderly failure rate was higher than that of younger people（< 60 years of age），the intercostal space < 9mm failure rate is higher than that of the intercostal space ≥9mm.，the difference had statistically significant（P<0.01）.Liver imaging showed abnormal

（liver hemangioma，nodules，cysts，liver，ascites，gas interference）in patients with 173 cases of failure detection，in which failure rate was 3.5%.In 52 cases，the failure rate was reduced to 240 by re examination of 3.8% cases，which was used to

re position the position，change the detecting position and adjust the direction of the probe.．Conclusion The failure of FibroScan measurement much due to obesity，narrow rib spaces，liver imaging showed abnormal（liver hemangioma，nodules，cysts，shrinking liver，ascites，gas interference，etc.）caused by，the elderly and women detection failure rate is higher.To detect the failure of the reasons，to take

the corresponding measures，can reduce the detection failure rate.

Key words Transient elastography；Liver stiffness measurement（LSM）；Failure rate

基于瞬时弹性成像技术的FibroScan 能够通过检测肝脏硬度值来判断肝纤维化的程度[1]，

具有无创、无痛、重复性好的优点，在我国已广泛用于临床，作为动态观察患者肝纤维化程