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目的：探讨肝细胞脂肪变性对肝脏弥散度成像技术（Realtime Tissue Elastography，RTE）无创评估病毒性肝炎肝纤维化及炎症程度的影响。方法：91 例确诊慢性乙型或丙型病毒性肝炎患者均于肝脏活检穿刺前行肝脏弥散度成像检查，分析不同肝细胞脂肪变性程度与肝纤维化程度及肝脏炎症程度之间的弥散度成像LF指数差异。结果：中度脂肪变性组LF 指数最高（P=0.0254）；轻度纤维化（S1-S2）时，不同的脂肪变性程度组间LF 值的差异无统计学意义（P=0.1105）；中- 重度纤维化时，不同的脂肪变性程度组间LF值的差异无统计学意义（P=0.0994）。轻度炎症时，不同的脂肪变性程度组间LF值的差异具有统计学意义，中度脂肪变性组的LF值最高（P=0.0010）；中- 重度炎症时，不同的脂肪变性程度组间LF值的差异具有统计学意义（P<0.05）。结论：应用肝脏弥散度成像的LF指数判断肝脏纤维化程度不受肝细胞脂肪变性的影响，但对于肝脏炎症程度的判断受肝细胞脂肪变性的影响，尤其应重视中度肝细胞脂肪变性对于测值的影响。

英文摘要:

Objective:To investigate the effect of hepatic steatosis on noninvasive evaluation of liver fibrosis and inflammation by RTE technology for patients with viral hepatitis.Methods:91 patients diagnosed with chronic hepatitis B/C underwent liver elasticity imaging examination before liver biopsy. To analyze the differences of LF indexes of liver with different stages of hepatic steatosis, hepatic fibrosis and inflammation.Results:LF index was the highest in moderate steatosis group (P=0.0254). The difference of LF values in mild fibrosis (S1-S2) was not statistically significant (P=0.1105). The difference was not statistically significant (P=0.0994), in mild inflammation, the difference of LF values between different groups was statistically significant, and the LF values of moderate steatosis group was the highest (P=0.0010); in moderate to severe inflammation, the difference of LF values between different groups was statistically significant (P<0.05).Conclusion:The LF index of liver dispersion imaging was used to determine the extent of liver fibrosis, but the effect of liver steatosis on liver inflammation, especially on the effect of moderate hepatic steatosis.

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