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1、瞬时弹性成像技术检测肝硬度失败原因及对策四川省达州市中心医院四川达州635000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20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%oBMI≥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
2、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%o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Abst
3、ractObjectiveToinvestigatethecauseofthefailureofthetransientelasticimaging(FibroScan)andthemethodofimprovingthesuccessrate.Methods5000casesweredetectedforliverstiffnesswithFibroScan,ineachcasewere10timesoftheeffectivemeasurement,andinpatientswithfailuredetectionforheight,weight,ribclearane
4、ewidthmeasurement,liverBultrasonicorCTexaminationandevaluationofbodymassindex,gender,age,intercostalspace,imageofthesuccessfuldetectionofinfluence.ResultsLSMfailureoccurredin4.8%ofallexaminations(240patientsoutof5000).Bodymassindex(BMI)≥28kg/m2failureratewassignificantlyhigherthanBMI<28
5、kg/m2.Thefailurerateoffemalepatientswithliverstiffnesswashigherthanthatofmale,theelderlyfailureratewashigherthanthatofyoungerpeople(<60yearsofage),theintercostalspace<9mmfailurerateishigherthanthatoftheintercostaIspace≥9mm.,thediffereneehadstatisticallysignificant(P<0.01).Liver
6、imagingshowedabnormal(liverhemangioma,nodules，cysts,liver,ascites，gasinterferenee)inpatientswith173casesoffailuredetection,inwhichfailureratewas3.5%Jn52cases，thefailureratewasreducedto240byreexaminationof3.8%cases,whichwasusedtorepositiontheposition,changethedetectingpositionandadjustthedi
7、rectionoftheprobe..ConclusionThefailureofFibroScanmeasurementmuchduetoobesity,narrowribspaces,liverimagingshowedabnormal(liverhemangioma,nodules,cysts，shrinkingliver，ascites,gasinterference，etc.)causedby,theelderlyandwornendetectionfailurerateishigher.Todetect
