Objective To assess the diagnostic value of acoustic structure quantification(ASQ) and compare the value of ASQ versus transient elastography( Fibroscan) in assessing live fibrosis in patients with chronic hepatitis B. Methods One hundred and eleven patients with chronic hepatitis B were enrolled in the study. All the patients in our study underwent ASQ,Fibroscan and liver biopsy. The correlation coefficient between pathological stages of liver fibrosis and FD Ratio,and the correlation coefficient between pathological stages of liver fibrosis and liver stiffness measurement were determined,and the receiver operating characteristic( ROC) curve of S≥2 and S=4 of ASQ and Fibroscan were analyzed. Results The correlation coefficient of liver fibrosis level was lower for FD Ratio ( rs =0. 659) than for liver stiffness measurement(rs =0. 777). The result showed statistical difference between the two groups. The areas under the ROC curve(AUC) set up for S≥2 and S=4 were 0. 705(95% CI:0. 611~0. 788) and 0. 817(95% CI:0. 733~0. 884) for ASQ and 0. 709(95% CI:0. 615~0. 791) and 0. 920(95% CI:0. 853~0. 963) for Fibroscan. There was no statistical difference between these two groups. The optimal cutoff values for fibrosis stages S≥2, S=4 respectively for the FD ratio were 0. 21(sensitivity 76%,speciality 74%)and 0. 38(sen-sitivity 77%,speciality 88%) . Conclusion ASQ is an emerging ultrasound technology which offers encouring re-sults in the diagnosis of pathological staging of hepatic fibrosis. As an effective parameter of ASQ,FD Ratio could be utilized for the follow-up and assessment of patients with chronic hepatitis B. The performance for assessing liver fi-brosis of ASQ is almost equal to that of Fibroscan,while ASQ can be combined with routine ultrasound systems, which has shown a promising value in assessing liver fibrosis in patients with chronic hepatitis B.%目的：评估组织结构声学定量技术( ASQ)对于肝纤维化病理分期的诊断效能,对比分析ASQ与瞬时弹性成像( Fibroscan)诊断肝纤维化病理分期的价值。方法收集慢乙肝患者111例,同时行ASQ、Fibroscan及肝脏病理穿刺活组织检查。对比ASQ定量参数红蓝曲线下面积比( FD Rati-o)、Fibroscan 肝弹性模量与肝纤维化病理分期的相关系数,绘制并分析肝纤维化病理分期的ROC曲线。结果 FD Ra-tio与肝纤维化病理分期的相关性(rs =0．659)低于Fibroscan弹性模量( rs =0．777),差异有统计学意义。 ASQ 与Fibroscan诊断肝纤维化病理分期S≥2、S=4的ROC曲线下面积分别为0．705(95%CI：0．611~0．788)与0．817(95%CI：0．733~0．884)、0．709(95%CI：0．615~0．791)与0．920(95%CI：0．853~0．963),差异无统计学意义。组织结构声学定量技术诊断肝纤维化(S≥2)、肝硬化(S=4)的最佳截断值分别为0．21(敏感度76%,特异度74%)、0．38(敏感度77%,特异度88%)。结论 ASQ作为一种新兴的超声新技术,对肝纤维化病理分期有一定的诊断价值,FD Ratio可作为无创性ASQ的有效参数,对慢性乙型肝炎患者的病情进行随访及评估。 ASQ对肝纤维化病理分期的评估效能与Fi-broscan相当,而ASQ能够与常规超声系统相结合,具有较好的临床应用前景。
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