声脉冲辐射力成像判别肝实性占位性病变良、恶性价值的初步研究

Value of acoustic radiation force impulse in the differential diagnosis of benign and malignant hepatic neoplasms

回顾性分析37例肝癌、52例肝血管瘤、8例肝局灶结节性增生（FNH）患者及40例正常对照者感兴趣区声触诊组织定量（VTQ）值及常规超声表现。在肝癌与肝血管瘤、FNH患者及正常对照者的VTQ值分别为（2．33±0．78）、（1．41±0．33）、（1．44±0．45）和（1．25±0．32）m／s，差异有统计学意义（均P〈0．01）；原发与转移性肝癌患者[（2．26±0．64）和（2．394-0．70）m／s]问差异无统计学意义（P〉0．05）；肝血管瘤、FNH患者及正常对照者间比较，差l异无统计学意义（均P〉0．05）。以VTQ=1．95m／s为阈值鉴别肝良、恶性病变，声脉冲辐射力成像（ARFI）与常规超声比较，诊断准确性差异有统计学意义（P〈0．01）。提示，ARFI技术能无创性量化反映肝内实性病变硬度，较常规检查能更明确诊断肿瘤的良、恶性。

To explore the value of acoustic radiation fierce impulse （ARFI） teehnique in the differential diagnosis of benign and malignant hepatic neoplasms. Retrospective analysis of touch tissue quantification （VTQ） and general ultrasonic examination of interesting region were performed tor hepatocellular carcinoma （HCC）, hepatic hemangioma, focal nodular hyperplasia （FNH） and controls. Significant differences existed between HCC and hepatic hemangioma, hepatic FNH and controls （ all P 〈 0. 01 ）. No significant differenee existed between primary and metastatic HCC （P 〉 0. 05 ）. There was no significant difference between hepatic hemanginma, FNH and controls （ all P 〉 0. 05 ）. With a cut-off VTQ value of 1.95 in/s, the sensitivity and accuracy rate in the differentiation of benign and malignant hepatic neoplasms was 90% and 83% respectively. The sensitivity and accuracy rate in general ultrasound examination of hepatic neoplasms was 88% and 70% respectively. Significant differences existed in accuracy rate between two methods （P 〈 0. 01 ）. It was confirmed that ARFI could reflect the stiffness of liver neoplasm noninvasively. Compared with general ultrasonography, ARFI is better at differentiating benign and malignant hepatic neoplasms.