声触诊组织定量技术鉴别诊断乙肝相关性小肝癌与肝硬化增生结节的应用价值

Application value of virtual touch tissue quantification in differential diagnosis of patients with HBV infection between small-hepatocellular carcinoma and dysplastic nodule

目的探讨声触诊组织定量(VTQ)技术鉴别诊断乙肝相关性小肝癌与肝硬化增生结节的临床价值。方法选取具有慢性乙肝病史且经手术或穿刺病理证实的小肝癌患者54例和肝硬化增生结节患者30例,均行常规超声及VTQ检查,获得其剪切波速度(SWV);绘制SWV诊断小肝癌的受试者工作特征(ROC)曲线,计算曲线下面积,确定最佳截断值并计算其敏感性、特异性、阳性预测值、阴性预测值、阳性似然比及阴性似然比。结果小肝癌患者的SWV为(3.45±1.44)m/s,肝硬化增生结节患者的SWV为(1.87±0.40)m/s,两者比较差异有统计学意义(P<0.05)。SWV诊断小肝癌的ROC曲线下面积为0.96,SWV截断值为2.455 m/s时敏感性为90.74%,特异性为93.33%,阳性预测值为96.08%,阴性预测值为84.85%,阳性似然比为13.61,阴性似然比为0.10。结论 VTQ技术能够通过SWV测值反映结节的硬度,在早期鉴别诊断乙肝相关性小肝癌与肝硬化增生结节中有重要价值。

Objective To investigate the value of virtual touch tissue quantification（VTQ）imaging in differentiating diagnosis for patients with HBV infection between small-hepatocellular carcinoma（s HCC） and dysplastic nodule（DN）.Methods Fifty-four patients with s HCC and 30 patients with DN,confirmed by surgery or biopsy were included in this study. All patients were examined by convention ultrasound and VTQ,the shear wave velocity（SWV）of the nodules and tissue surounding nodule were detected.Receiver operating characteristic（ROC） curve,area under ROC curve（AUROC）,sensitivity,specificity,positive predictive value,negative predictive value,positive likelihood ratio and negative likelihood ratio were calculated,respectively. Results The SWV value of s HCC [the mean SWV was（3.45±1.44）m/s] was significantly higher than that of the DN[the mean SWV was（1.87±0.40）m/s）],there was significant difference（P〈0.05）.The AUROC for s HCC was 0.96,with a cut-off value of 2.455 m/s,the sensitivity,specificity,positive predictive value,negative predictive value,positive likelihood ratio and negative likelihood ratio for differentiating between the benign and the malignant nodules were 90.74%,93.33%,96.08%,84.85%,13.61 and 0.10,respectively. Conclusion VTQ provides the stiffness of benign and malignant nodules through SWV,which is potentially valuable in differentiating diagnosis in patients with HBV infection between small hepatocelluar carcinoma and dysplastic nodule.