比较声辐射脉冲成像（ARFI）技术与谷草转氨酶/血小板比值（APRI）对非酒精性脂肪性肝病肝纤维化诊断的价值。

选取2012年5月至2015年5月深圳巿第三人民医院收治的136例非酒精性脂肪性肝病患者，采用ARFI技术检测肝脏超声弹性。分别采用全自动的生化分析仪与血细胞分析仪检测患者谷草转氨酶（AST）、血小板（PLT），并计算APRI指数。所有患者均于检测后1周内行肝脏穿刺活检。以病理检查结果为"金标准"，比较ARFI技术与APRI指数诊断非酒精性脂肪性肝病肝纤维化的价值。

所有患者均行ARFI检测，与S0、S1期患者的ARFI指数比较，S4期患者的ARFI指数均明显增加，差异有统计学意义（P均<0.05）；不同纤维化分期患者间APRI指数比较，差异无统计学意义（P>0.05）；ARFI诊断非酒精性脂肪性肝病肝纤维化≥S2、≥S3及S4期的ROC曲线下面积分别为0.714、0.765、0.853，而APRI为0.653、0.577、0.611。与APRI比较，ARFI技术评价非酒精性脂肪性肝病不同肝纤维化程度的ROC曲线下面积明显增加，尤以S4的曲线下面积最大，ARFI值1.362 m/s为诊断重度肝纤维化的界值。

与APRI指数比较，ARFI技术检测非酒精性脂肪性肝病肝纤维化程度更为准确、且为无创定量评价，具有一定的推广价值。

To investigate the diagnostic value of the acoustic radiation force impulse (ARFI) imaging technology and AST/PLT ratio index (APRI) for the assessment of the liver fibrosis in non-alcoholic fatty liver disease (NAFLD) patients.

One hundred and thirty-six patients with NAFLD were included from May 2012 to May 2015 in the Third People′s Hospital of Shenzhen. The subjects underwent liver biopsy, liver function and blood count test, as well as real-time ultrasonic elastography examination. The measurements of real-time ultrasonic elastography by ARFI technology used an ultrasonic instrument ACUSON S2000. The APRI was calculated according to the following formula, APRI=AST/PLT. ARFI and APRI were compared by correlation with liver fibrosis stage in NAFLD. Referring to the histologic fibrosis stage on liver biopsy, all the ARFI and the APRI value were assessed by using receiver operating characteristic (ROC) curve analysis. The corresponding cut-off values, sensitivity and specificity were also calculated and compared. One hundred and thirty-six patients with non alcoholic fatty liver disease were included in this study. Both of ARFI and APRI index were measured and calculated, and the results were compared with the pathological examination as gold standard.

All patients underwent ARFI test. Compared with the patients with S0 and S1, the ARFI of S4 were decreased significantly and the difference was statistically significant (both P<0.05). There was no significant difference in APRI index (P>0.05) among different stages of fibrosis. ROC curve of different diagnosis methods were drawn.. The area under the ROC curve of diagnosing S2, S3 and S4 or higher stages nonalcoholic fatty liver disease by ARFI were 0.714, 0.765, 0.853, and corresponding value of APRI were 0.653, 0.577 and 0.611. Compared with the APRI index, the area under the ROC curve of the ARFI technique in evaluating the degree of liver fibrosis in non alcoholic fatty liver disease was increased significantly, and the area under the curve of S4 was the highest. The cut-off ARFI index of diagnosing severe hepatic fibrosis was 1.362 m/s.

As a non-invasive technology, ARFI is more accurate in evaluating liver fibrosis in patients with NAFLD than APRI. ARFI technology has potential value for quantitative evaluation of the liver fibrosis for NAFLD.