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摘要：
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摘要：目的 探讨超声造影与声触诊组织量化（virtual touch tissues quantification，VTQ）技术在肝硬化
诊断中的价值。方法 选取2017年3月至2019年3月于海南省人民医院诊治的128例肝硬化患者为肝硬化
组，126例同期健康体检者为对照组，均接受VTQ技术及超声造影检查。记录两组肝静脉、肝动脉、
门静脉及肝实质内造影剂开始显影时间（arriving time，AT）、达峰值时间（peak time，PT）及峰值强
度（peak intensity，PI），计算肝动脉-肝静脉渡越时间（hepatic artery to hepatic vein transit time，HA-
HVTT）、门静脉-肝静脉渡越时间（portal vein to hepatic vein transit time，PV-HVTT）及门静脉-肝动脉
渡越时间（hepatic artery to portal vein transit time，HA-PVTT）。记录两组VTQ值。采用受试者工作特
征（receiver operator characteristic，ROC）曲线比较超声造影与VTQ技术诊断肝硬化价值的差异。结果
肝硬化组患者肝静脉AT显著短于对照组[（20.98 ± 4.36）s vs （20.98 ± 4.36）s；t = 5.844，P ＜ 0.001]，
肝动脉和门静脉AT差异无统计学意义[（14.03 ± 3.67）s vs（13.26 ± 3.25）s，t = 1.769，P = 0.078；
（15.51 ± 3.68）s vs（15.38 ± 4.02）s，t = 0.269，P = 0.788]。肝硬化组患者肝动脉PT显著长于对照
组[（28.06 ± 5.02）s vs（25.98 ± 5.68）s；t = 3.094，P = 0.002]，肝静脉和肝实质PT显著短于对照组
[（43.25 ± 7.15）s vs（45.01 ± 7.02）s，t = 1.979，P = 0.049；（44.98 ± 8.16）s vs（35.24 ± 6.84）s，t = 10.301，
P ＜ 0.001]，门静脉PT差异无统计学意义[（35.93 ± 6.74）s vs（36.05 ± 6.97）s，t = 0.139，P = 0.889]。肝硬
化组患者肝动脉、门静脉和肝实质PI均显著低于对照组[（35.28 ± 5.24）dB vs（38.02 ± 6.67）dB，t =
3.644，P ＜ 0.001；（34.87 ± 5.03）dB vs（38.15 ± 6.82）dB，t = 4.367，P ＜ 0.001；（24.67 ± 5.42） dB vs
（27.98 ± 4.68）dB，t = 5.206，P ＜ 0.001]，肝静脉PI差异无统计学意义[（36.03 ± 6.91）dB vs（35.96 ±
6.79）；t = 0.081，P = 0.935]。肝硬化组患者HA-HVTT [（6.95 ± 1.59）s vs（11.04 ± 3.02）s]、HA-
PVTT [（1.48 ± 0.25）s vs（2.12 ± 0.61）s]及PV-HVTT [（5.47 ± 1.39）s vs（8.92 ± 2.02）s]均短于对
照组，差异有统计学意义（t = 13.535、10.971、15.878，P均＜ 0.001）。肝硬化组患者肝右叶VTQ
值为（2.31 ± 0.40）m/s，显著高于对照组的（1.03 ± 0.19）m/s，差异有统计学意义（t = 32.492，
P ＜ 0.001）。ROC曲线表明，VTQ技术诊断肝硬化的曲线下面积（area under curve，AUC）为
0.965，最佳临界值为1.755 m/s，敏感性为0.914，特异度为0.917。超声造影3项定量参数（HA-
HVTT、HA-PVTT、PV-HVTT）联合诊断的AUC为0.903，敏感性为0.789，特异度为0.873。VTQ技术
AUC和特异度显著高于超声造影（Z = 2.939，P = 0.003；χ 2 = 6.527，P = 0.011），敏感性差异无统计
学意义（χ 2 = 2.153，P = 0.142）。结论 VTQ技术对肝硬化的诊断价值高于超声造影，可提高临床肝
硬化诊断效能。
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Abstract: Objective To investigate the diagnostic value of ultrasonic contrast and virtual touch tissues
quantification (VTQ) on liver cirrhosis. Methods Total of 128 patients with liver cirrhosis in Hainan people’s
Hospital from March 2017 to March 2019 were selected as liver cirrhosis group, and 126 healthy subjects
were selected as control group. All subjects received VTQ and ultrasonic contrast. The arriving time (AT),
peak time (PT) and peak intensity (PI) of hepatic vein, hepatic artery, portal vein and liver parenchyma
were recorded, hepatic artery to hepatic vein transit time (HA-HVTT), portal vein to hepatic vein transit time
(PV-HVTT) and hepatic artery to portal vein transit time (HA-PVTT) were calculated. The VTQ values of
right hepatic lobe were also recorded. Receiver operator characteristic (ROC) curve were used to compare the
diagnostic value of ultrasonic contrast and VTQ on liver cirrhosis. Results Hepatic vein AT of patients in liver
cirrhosis group was significantly shorter than that in control group [(20.98 ± 4.36) s vs (20.98 ± 4.36) s; t =
5.844, P ＜ 0.001], and there were no significant differences in hepatic artery and portal vein AT between the
two groups [(14.03 ± 3.67) s vs (13.26 ± 3.25) s, t = 1.769, P = 0.078; (15.51 ± 3.68) s vs (15.38 ± 4.02) s, t =
0.269, P = 0.788]. Hepatic artery PT of patients in liver cirrhosis group was significantly longer than that in
control group [(28.06 ± 5.02) s vs (25.98 ± 5.68) s; t = 3.094, P = 0.002], hepatic vein and liver parenchyma PT
in liver cirrhosis group were significantly shorter than those in control group [(43.25 ± 7.15) s vs (45.01 ± 7.02) s, t =
1.979, P = 0.049; (44.98 ± 8.16) s vs (35.24 ± 6.84) s, t = 10.301, P ＜ 0.001], and there was no significant
difference in portal vein PT between the two groups [(35.93 ± 6.74) s vs (36.05 ± 6.97) s, t = 0.139, P = 0.889].
Hepatic artery, portal vein and liver parenchyma PI of patients in liver cirrhosis group were significantly lower
than those in control group [(35.28 ± 5.24) dB vs (38.02 ± 6.67) dB, t = 3.644, P ＜ 0.001; (34.87 ± 5.03) dB
vs (38.15 ± 6.82) dB, t = 4.367, P ＜ 0.001; (24.67 ± 5.42) dB vs (27.98 ± 4.68) dB, t = 5.206, P ＜ 0.001], there
was no significant difference in hepatic vein PI between the two groups [(36.03 ± 6.91) dB vs (35.96 ± 6.79);
t = 0.081, P = 0.935]. HA-HVTT [(6.95 ± 1.59) s vs (11.04 ± 3.02) s], HA-PVTT [(1.48 ± 0.25) s vs (2.12 ± 0.61) s]
and PV-HVTT [(5.47 ± 1.39) s vs (8.92 ± 2.02) s] of patients in liver cirrhosis group were significantly shorter
than those in control group, the differences were statistically significant (t = 13.535, 10.971, 15.878; all P ＜ 0.001).
The VTQ value of the right hepatic lobe of patients in liver cirrhosis group were higher than that in control
group [(2.31 ± 0.40) m/s vs (1.03 ± 0.19) m/s], the difference was statistically significant (t = 32.492, P ＜
0.001). ROC curve showed that the area under curve (AUC) of VTQ on diagnosis of liver cirrhosis was 0.965,
the optimal threshold was 1.755 m/s, the sensitivity was 0.914 and the specificity was 0.917. The AUC of HA-
HVTT, HA-PVTT and PV-HVTT combined diagnosis was 0.903, the sensitivity was 0.789 and the specificity
was 0.873. The AUC and specificity of VTQ were significantly higher than those of ultrasonic contrast (z =
2.939, P = 0.003; χ 2 =6.527, P = 0.011), and there was no significant difference in sensitivity (χ 2 = 2.153, P =
0.142). Conclusions The diagnostic value of VTQ technique on liver cirrhosis is higher than that of ultrasonic
contrast, which can improve the clinical diagnostic efficiency of liver cirrhosis.
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