声辐射力脉冲成像技术对肝占位性病变的诊断价值

Value of acoustic radiation force impulse in qualitative diagnosis of hepatic tumors

目的 探讨声辐射力脉冲成像技术(ARFI)对肝占位性病变良、恶性鉴别诊断的临床价值。方法 采用灰阶超声和ARFI技术对63例肝肿瘤患者(共80个病灶)进行检查,对所有病灶的硬度进行半定量分析,并将其与病理结果对照分析,计算超声弹性成像诊断肝脏恶性肿瘤的敏感性、特异性及准确性。结果 恶性结节超声弹性图像评分明显高于良性结节,差异有统计学意义(P<0.01)。以弹性评分≥3分为诊断界点,诊断为良性病变者39个,恶性病变者41个,误诊7个,诊断敏感性、特异性及准确性分别为83.89%、80.00%和91.18%。结论 ARFI技术可识别肝占位性病变和正常组织间的弹性差异,对肝占位性病变良恶性有一定的诊断价值。

Objective To explore the clinical value of acoustic radiation force impulse （ARFI） technology in the differentiation of hepatic benign and malignant tumors. Methods Eighty hepatic tumors in 63 cases were scaned by grey scale uhrasonograghy and ARFI. The stiffness of all tumors was analyzed semi-quantitatively, and the results were compared with the pathological types. The sensitivity, specificity and accuracy of ultrasonic elastography in the diagnosis of hepatic malignant tumor were calculated. Results Ultrasonic elastography scores of malignant nodules were significantly higher than those of benign nodules, and there was a significant difference（P〈0.01 ）. Elastic score≥3 was used as diagnostic critical point. Thirty-nine benign lesions were diagnosed,41 malignant lesions were diagnosed and 7 lesions were misdiagnosed. The sensitivity, specificity and accuracy of ARFI for diagnosing benign and malignant lesions were 83.89%, 80.00% and 91.18%, respectively. Conclusion ARFI technology can identify elasticity difference between hepatic tumors and normal tissue, which has certain value in the diagnosis of hepatic benign and malignant tumors.