实时超声弹性成像技术对肝脏肿瘤的诊治效果

Clinical values of real-time ultrasound elastography in diagnosis and treatment of liver tumors

目的探讨实时超声弹性成像技术对肝脏肿瘤良恶性鉴别以及对恶性肿瘤射频治疗后疗效的评定。方法选取2011年3月至2014年3月间收治的130例肝脏病变患者,采用实时超声弹性成像技术观察肝脏肿瘤的良恶性,并对采用射频治疗后的肝脏恶性肿瘤进行疗效评定。结果良性病变平均分值为(1.87±0.32)分,明显低于恶性肿瘤的(3.17±0.52)分,差异有统计学意义(P<0.05)。弹性成像诊断恶性肿瘤的敏感性为87.2%,特异性为83.3%,阳性预测值为91.1%,阴性预测值76.9%,诊断效率为85.9%。患者术后即刻、术后3个月、术后半年消融灶体积最大值明显小于术前(P<0.05);患者术后即刻、术后3个月、术后半年消融灶体积呈递减趋势,差异有统计学意义(P<0.05)。弹性评分标准示术后即刻、术后3个月、术后半年弹性评分平均值分别为(2.37±0.31)分、(2.11±0.26)分和(1.93±0.18)分,明显小于术前的(3.17±0.52)分,差异有统计学意义(P<0.05)。术前及术后不同随访时间患者消融灶的弹性评分与体积存在明显相关性(P<0.01)。结论实时超声弹性成像技术对肝脏肿瘤诊治效果明显,其弹性评分与患者术后消融面有较高相关性,能够用于评价患者射频消融手术治疗效果。

Objective To discuss the value of real-time ultrasound elastography for differential diagnosis of liver neoplasm and assess the therapeutic effect of radiofrequency ablation.Methods A total of130 cases of patients with liver disease in the Second People＇s Hospital of Yibin City were included.All patients underwent real-time ultrasound elastography,and the result of real-time ultrasound elastography in the treatment of liver tumor was observed.Results The average score of benign lesions was（1.87 ± 0.32）,which is significantly less than that of malignant lesions（3.17 ± 0.52,P〈0.05）.The elastography sensitivity was 87.2%,specificity was 83.3%,positive predictive value was 91.1%,negative predictive value was 76.9%,and overall accuracy was 85.9%.The maximum size of ablative foci of patients with instantly after the operation,3 months after the operation,6 months after the operation was significantly smaller than that of pre-operation（P〈0.05）.The size of ablative foci of patients with instantly after the operation,3months after the operation,6 months after the operationtook a decreasing trend.There was significant difference（P〈0.05）.The average elastic scores of patients with instantly after the operation,3 months after the operation,6 months after the operation were（2.37 ± 0.31）,（2.11 ± 0.26） and（1.93 ± 0.18）,which were significantly smaller than that of pre-operation（3.17 ± 0.52,P〈0.05）.The elastic scores of patients during different follow-up timebefore and after surgery were significantly associated with the size of ablative foci（P〈0.01）.Conclusion Rreal-time ultrasound elastography has application value in diagnosing liver tumor,and the elastic scorewas significantly associated with the size of ablative foci.This method is helpful for assessing the treatment result of radiofrequency ablation.