超声多模态成像鉴别肝脏局灶病变良恶性的价值

Value of Multimodal Ultrasonography in Differentiating Malignant Focal Liver Lesions from Benign Ones

目的:研究多模态超声鉴别肝脏局灶性病变(focal Liver Lesions,FLLs)良恶性的价值。方法:纳入85例于我院发现FLLs的患者,对所有患者共150个FLLs行常规超声,超声造影(contrast-enhanced ultrasound,CEUS),剪切波弹性成像(shearwave elastography,SWE)检查。绘制常规超声、CEUS,SWE以及CEUS+SWE联合诊断的受试者工作特征曲线(receiver operator characteristic curve,ROC),比较几种超声检查方式鉴别FLLs良恶性的能力。结果:将成功完成前述检查,并获得满意图像的75例患者共129个FLLs纳入统计,其中SWE+CEUS联合诊断的曲线下面积(area under the curve,AUC)值高于CEUS及SWE单独诊断(P<0.05),SWE参数E-max及E-mean单独诊断的AUC值大于CEUS单独诊断(P_(max)=0.797,P_(min)=0.050),E-min单独诊断的AUC值小于CEUS单独诊断(P=0.774),差异均无统计学意义。SWE+CEUS,SWE,CEUS诊断效能明显高于常规超声(P<0.05)。结论:CEUS及SWE能有效鉴别FLLs良恶性,两者联合的多模态成像能提高FLLs良恶性鉴别的准确率。

Objective:The purpose of this study is to evaluate the diagnostic value of multimodal ultrasonography in focal liver lesions(FLLs).Methods:We included 85 patients with 150 FLLs in our study、All 150 FLLs were examined by greyscale ultrasound,CEUS and SWE.Traditional ultrasound,CEUS,SWE and SWE+CEUS were compared by drawing ROC curve to identify their efficacy in differentiating benign FLLs from malignant ones.Results:129 cases of FLLs from 75 patients who successfully completed the above examinations and had obtained satisfactory images were statistically analyzed.The AUC of SWE+CEUS was higher than those of CEUS and SWE alone,respectively(P<0.05).The AUC of SWE parameters,E-max and E-mean,were higher than that of CEUS(P_(max)=0.797,P_(min)=0.050).The AUC of E-min alone was lower than that of CEUS alone(P=0.774).Diagnostic effects of SWE+CEUS,SWE alone and CEUS alone were significantly higher than that of conventional ultrasound(P<0.05).Conclusion:CEUS and SWE can effectively identify benign and malignant FLLs.The combined use of CEUS and SWE can greatly improve the accuracy of ultrasound in differentiating benign FLLs from malignant ones.