腹部超声中实时组织弹性成像联合剪切波速度测量在肝脏局灶性病变中的诊断价值

Diagnostic Value of Real-Time Tissue Elastography Combined with Shear Wave Velocity Measurement in Focal Liver Lesions Using Abdominal Ultrasound

目的 分析腹部超声中实时组织弹性成像联合剪切波速度测量在肝脏局灶性病变中的诊断价值。方法 选择2019年3月至2021年3月郑州颐和医院收治的90例肝脏局灶性病变患者作为研究对象,所有患者均接受腹部超声中实时组织弹性成像与剪切波速度测量,以术后病理结果作为金标准,对比腹部超声中实时组织弹性成像联合剪切波速度测量诊断在肝脏局灶性病变性质中的鉴别价值。绘制受试者工作特征(ROC)曲线,分析腹部超声中实时组织弹性成像、剪切波速度测量及联合检测对肝脏局灶性病变性质中的鉴别价值。结果 以术后病理诊断结果为金标准,90例肝脏局灶性病变患者中恶性肿瘤有53个(58.89%),其中肝细胞癌35个(66.04%),肝转移癌10个(18.87%),胆管细胞癌8个(15.09%);良性肿瘤37个(41.11%),其中肝硬化结节12个(32.43%),血管瘤17个(45.94%),腺瘤4个(10.81%),炎性结节4个(10.81%)。腹部超声中实时组织弹性成像、剪切波速度测量及联合与金标准的一致性分别为0.402、0.586、0.767。三种诊断方式的特异度对比差异无统计学意义(P> 0.05);腹部超声中实时组织弹性成像、剪切波速度及联合诊断的准确度、灵敏度对比,以联合诊断最高,差异均有统计学意义(P <0.05);ROC曲线显示,腹部超声中实时组织弹性成像、剪切波速度及联合对肝脏局灶性病变的曲线下面积(AUC)分别为0.709(95%CI:0.599~0.818)、0.809(95%CI:0.716~0.901)、0.877(95%CI:0.794~0.960)。结论 腹部超声中实时组织弹性成像与剪切波速度均可有效鉴别肝脏局灶性病变性质,但通过联合检测的方式可提高诊断效能,值得应用。

Objective To analyze the diagnostic value of real-time tissue elastography combined with shear wave velocity measurement in focal liver lesions using abdominal ultrasound.Methods Ninety patients with focal liver lesions treated at Zhengzhou Yihe Hospital from March 2019 to March 2021 were selected as study subjects.All patients underwent real-time tissue elastography and shear wave velocity measurement using abdominal ultrasound.Postoperative pathological results were used as the gold standard to compare the diagnostic value of real-time tissue elastography combined with shear wave velocity measurement in differentiating the nature of focal liver lesions.Receiver operating characteristic(ROC)curves were plotted to analyze the diagnostic value of real-time tissue elastography,shear wave velocity measurement,and their combination in differentiating the nature of focal liver lesions.Results Based on postoperative pathological diagnosis,53 out of 90 patients(58.89%)had malignant tumors,including 35 cases(66.04%)of hepatocellular carcinoma,10 cases(18.87%)of liver metastases,and 8 cases(15.09%)of cholangiocarcinoma.Thirty-seven patients(41.11%)had benign tumors,including 12 cases(32.43%)of cirrhotic nodules,17 cases(45.94%)of hemangiomas,4 cases(10.81%)of adenomas,and 4 cases(10.81%)of inflammatory nodules.The consistency of real-time tissue elastography,shear wave velocity measurement,and their combination with the gold standard were 0.402,0.586,and 0.767,respectively.There was no statistically significant difference in specificity among the three diagnostic methods(P>0.05).The accuracy and sensitivity of the combined diagnosis were the highest,with statistically significant differences(P<0.05).The ROC curve showed that the area under the curve(AUC)for real-time tissue elastography,shear wave velocity measurement,and their combination in diagnosing focal liver lesions were 0.709(95%CI:0.599~0.818),0.809(95%CI:0.716~0.901),and 0.877(95%CI:0.794~0.960),respectively.Conclusion Real-time tissue elastography and shear wave velocity measurement using abdominal ultrasound can effectively differentiate the nature of focal liver lesions.However,the combined detection method can improve diagnostic efficiency and is worthy of application.