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Preliminary Study of Virtual Touch Quantification in Differential Diagnosis of Substantial Diffuse Liver Disease

Author: ZengLingRong
Tutor: ZhouPing
School: Central South University
Course: Medical Imaging and Nuclear Medicine
Keywords: Virtual touch quantification Liver cirrhosis Hepatitis B chronic Fatty liver
CLC: R445.1
Type: Master's thesis
Year: 2011
Downloads: 95
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Abstract


BackgroundLiver cells necrosis, fibrosis and hepatocyte nodules regeneration staggered repeatedly under a variety of causes or continuous inflammatory injury, and develop to liver cirrhosis eventually. Be timely treated, substantial diffuse liver disease and even early cirrhosis can be reversed. Therefore, early accurate diagnosis has important clinical value.Ultrasound elastography is a new imaging technology for biological tissue elasticity characteristics, and becoming a focus of clinical research, which extends the theory and application of ultrasonic diagnosis. Changes of tissue elasticity are often associated with abnormal pathological state. Different organizational structures or the same structural in different pathological conditions has different elasticity or hardness. The changes of shape and hardness occur in the gradual process of chronic liver disease. Acoustic communication in the liver parenchyma during the particle displacement can generate shear waves. Theoretically, the liver hardness can be judged by shear wave velocity and physical characteristics related with medium hardness.Objectives1.To compare the success rate of obtaining satisfied VTQ value and the VTQ value of the left and right hepatic lobe among 16 cases of normal person, to obtain a better sampling site.2.To compare the VTQ value of 35 patients with liver cirrhosis,33 cases with hepatitis B chronic,21 cases with fatty liver and 16 normal cases as control group,to evaluate the value of VTQ in the differential diagnosis of substantial diffuse liver disease.Methods1.VTQ was performed in 16 cases of normal person, the success rate of obtaining satisfied VTQ value and the VTQ value of the left and right hepatic lobe were detected in 1 cm at the bottom of the envelope of right hepatic lobe, and the difference between them was compared.2.VTQ was performed in 35 patients with liver cirrhosis,33 cases with hepatitis B chronic,21 cases with fatty liver and 16 normal cases as control group. VTQ was detected in 1 cm below the envelope of right hepatic lobe. Analysis of variance was adopted to compare VTQ values of each group, obtaining cutoff values of each group by ROC, and calculate the coefficient of variation of VTQ D-value obtained by two operators.ResultsSatisfied VTQ values were obtained in the right hepatic lobe in 16 normal cases, and not obtained in the left hepatic lobe in 4 cases. Success rate of obtaining satiafied VTQ in the left and right hepatic lobe was significantly different (X2=5.926, p<0.05) by chi-square test. Reference VTQ values of the left and right hepatic lobe were (1.25±0.14)m/s> (1.24±0.10)m/s, reapectively. They weren’t significantly different(P>0.05). There was significant difference of VTQ 1 cm below the envelope of the right hepatic lobe among groups. VTQ:liver cirrhosis> hepatitis B chronic>normal group>fatty liver(P<0.05). The optimal cutoff values for differential diagnosing fatty liver from normal population was 0.99 m/s, with the sensitivity of 71.4% and specificity of 93.7% respectively. The optimal cutoff values for differential diagnosing hepatitis B chronic from normal population was 1.4 m/s，with the sensitivity of 88% and specificity of 95% respectively. The optimal cutoff values for differential diagnosing liver cirrhosis from hepatitis B chronic was 1.7 m/s, with the sensitivity of 90.9% and specificity of 81.2% respectively. Coefficient of VTQ variation between the two operators was 0.188.Conclusions1.VTQ values of left and right hepatic lobe in normal people have no significant difference. The success rate of VTQ imaging in right lobe is significantly higher than in left lobe.2.VTQ imaging does not depend on the operator and acoustic window selected,which can be used in displacement site which can not be reached by manual pressure. 3.VTQ imaging can effectively differentiate from liver cirrhosis, chronic hepatitis B fibrosis, fatty liver, with advantages of non-invasive, painless, quick, simple, objective and so on. It is a more sensitive detection technology for liver stiffness.

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