超声实时组织弹性成像在肝脏局灶性结节性增生与肝腺瘤鉴别诊断中的应用价值  

Value of real-time tissue elastography in differential diagnosis of focal nodular hyperplasia and hepatocellular adenoma

作　　者：洪峻峰[1] 郭佳[1] 梁丽琼[1] 冀建峰[2] 

机构地区：[1]第二军医大学东方肝胆外科医院超声科,上海200438 [2]解放军94医院超声科,南昌330002

出　　处：《第二军医大学学报》2014年第5期524-528,共5页Academic Journal of Second Military Medical University

基　　金：上海市科委医学重点发展基金(10411951900)~~

摘　　要：目的探讨超声实时组织弹性成像（real—time tissue elastography，RTE）在肝脏局灶性结节性增生（focal nodu—lar hyperplasia，FNH）与肝腺瘤（hepatocellular adenoma，HCA）鉴别诊断中的应用价值。方法回顾性分析经术后病理证实的20例FNH（22个病灶）和8例HCA（9个病灶）患者的超声RTE检查资料，采用5分法对弹性图像进行评分并测量其应变率比值（strainratio，SR），比较FNH和HCA弹性图像评分和SR的差异。结果FNH弹性图像评分以3～4分为主（18／22，81．8％），而HCA评分以1分为主（5／9，55．6％），两者的评分差异存在统计学意义（P=0．0002）；FNH和HCA的应变率比值分别为7．47±4．53、1．64±0．88，差异具有统计学意义（P〈0．0001）。结论超声RTE显示FNH硬度明显高于HCA，是对常规超声的有力补充，有助于两者的鉴别诊断。Objective To investigate the value of real-time tissue elastography （RTE） in the differential diagnosis of focal nodular hyperplasia （FNH） and hepatocellular adenoma （HCA）. Methods The RTE data of 20 patients with pathologically proven FNH （22 lesions） and 8 patients with HCA （9 lesions） were retrospectively analyzed. The RTE data were evaluated by scores（grades 1-5）and the strain ratios （SR） of the nodules were calculated and compared between the two groups. Results Most FNH lesions had a grade of 3-4（18/22,81.8%）on elastography, while most lesions of HCA had a grade of 1 （5/9,55.6 %）on elastography, with significant difference found between the two groups （P =0. 000 2）. The strain ratio of FNH was significantly higher than that of HCA（7. 47±4. 53 vs 1.64±0.88, P〈0. 000 1）. Conclusion The stiffness of FNH in RTE is notably higher than that of HCA, indicating RTE may be a supplementary to routine ultrasonic examination, which may be helpful for differential diagnosis of FNH and HCA.

关 键 词：超声检查 弹性成像技术 肝疾病局限性结节状增生 腺瘤 

分 类 号：R735.7[医药卫生—肿瘤]