超声应变比值法与弹性成像评分法对肝局灶性病变性质判断价值比较

Comparison of the diagnostic values between strain ratio and ultrasound elastography scoring in differentiating natures of focal liver lesions

目的探讨超声应变比值法(SR)与弹性成像评分法(UES)对肝脏局灶性病变(FLL)性质的鉴别诊断价值。方法选择我院69例临床诊断FLL患者共77个病灶,术前均分别接受SR检查及UES评分。构建受试者工作特征(ROC)曲线,以手术病理诊断结果为金标准,比较SR法及UES评分法判断FLL性质的诊断价值及诊断效率。结果良性患者39例(45个病灶),恶性患者30例(32个病灶)。SR诊断FLL性质的AUC为0.925,95%CI:0.884~0.973;UES评分的AUC为0.912,95%CI:0.825~0.961。SR诊断FLL性质的敏感性、特异性及准确度分别为93.33%、90.63%、92.21%;而UES评分诊断的敏感性、特异性及准确度分别为:86.67%、78.13%、83.12%。两种检查方法敏感性、特异性及准确度比较,差异均有统计学意义(P<0.05)。结论 SR检查及UES评分均具有较好诊断价值,而SR检查能更加有效鉴别诊断FLL良恶性。

Objective To evaluate the differential diagnosis value of the strain ratio （SR） and ultrasoUnd elastography scoring （UES） for nature of focal liver lesions （FLL）. Methods Sixty-nine patients with 771 esions in our hospital were selected. All patients received pre-operational SR and UES evaluation. The diagnostic performances of the SR and UES were evaluated with receiver operating characteristic curve （ROC） analysis, The pathologic diagnosis was regarded as gold standard. The diagnosis values and diagnosis effect were compared between the SR and UES. Results There were 39 patients with 45 benign 1 esions and 30 patients with 32 malignant le sions. The AUC of the SR was 0. 925 with 95% CI = 0. 884 -0. 973 ,and the AUC of the UES was 0.912 with 95% CI = 0. 825- 0. 961. The sensitivity, specificity and accuracy of the SR in diagnosing FLL were 93.33% ,90. 63 % and 92. 21%, respectively while the UES had 86. 67% ,78.13% and 83.12% , respectively. The differences in the diagnostic sensitivity, specificity and accuracy between the two methods were statistically significant （ P 〈 0. 05 ）, Conclusion The SR and UES methods have good clinical values, but the SR method can more effectively evaluate the nature of FLL than the UES method.