实时剪切波超声弹性成像对肝脏局灶性结节性增生及肝腺瘤的鉴别诊断  

Clinical research of real time shear wave elastography in differential diagnosis of focal nodular hyperplasia and hepatocellular adenoma

作　　者：宋毅[1] 程敬亮[2] 郑权[1] 孙璐璐[1] 霍婷婷[1] 

机构地区：[1]郑州大学第一附属医院超声科,郑州450052 [2]郑州大学第一附属医院磁共振科,郑州450052

出　　处：《郑州大学学报（医学版）》2016年第6期784-787,共4页Journal of Zhengzhou University(Medical Sciences)

摘　　要：目的:研究肝脏局灶性结节性增生(FNH)和肝腺瘤(HA)的实时剪切波超声弹性成像(SWE)声像图特点,探讨SWE在FNH和HA鉴别诊断中的临床应用价值。方法:选取34个FNH及12个HA的肝脏占位性病变,行SWE检查,获取病变的杨氏模量平均值、病变与邻近肝组织杨氏模量平均值的比值(杨氏模量比值),所有病变均以病理检查结果为金标准,对SWE鉴别诊断FNH和HA的准确性进行评价。结果:FNH组杨氏模量平均值为(40.56±13.37)k Pa,HA组为(14.33±7.81)k Pa;FNH组杨氏模量比值为(6.42±2.13),HA组为(2.45±1.61);FNH组与HA组比较,差异均有统计学意义(P均<0.001)。通过ROC曲线确定FNH和HA杨氏模量平均值的临界点为14.45 k Pa,其敏感度97.1%、特异性93.3%,曲线下面积为96.1%;杨氏模量比值的临界点为6.32,其敏感度98.2%、特异性67.4%,曲线下面积为97.2%。结论:SWE在FNH及HA鉴别诊断中具有重要临床价值。Aim： To evaluate the sonographic features of real-time shear wave elastography（ SWE） in patients with focal nodular hyperplasia（ FNH） and hepatocellular adenoma（ HA） and investigate the clinical application value of SWE in differential diagnosis of FNH and HA. Methods： There were 34 cases in the FNH group and 12 cases in the HA group in the study. All the cases were performed SWE,the mean elasticity of Young＇ s modulus of the lesions and the ratio of the mean elasticity of Young＇s modulus of the lesions to that of the surrounding liver（ the ratio of the mean elasticity of Young＇s modulus） were obtained. All the lesions were confirmed by pathologies as the gold standard. SWE results were compared with the pathologies to evaluate the accuracy using SWE to diagnose the FNH and HA. Results： The mean elasticity of Young＇s modulus of the lesions was（ 40. 56 ± 13. 37） k Pa in FNH group and（ 14. 33 ± 7. 81） k Pa in HA group. The ratio of the mean elasticity of Young＇s modulus was（ 6. 42 ± 2. 13） in FNH group and（ 2. 45 ± 1. 61） in HA group. The mean elasticity of Young＇s modulus of the lesions and the ratio of the mean elasticity of Young＇ s modulus had significant difference between FNH and HA groups（ P 0. 001）. The critical point of the mean elasticity of Young＇s modulus of the lesions between FNH and HA was 14. 45 k Pa by ROC curve,the sensitivity was 97. 1%,and specificity was 93. 3%. The area under the ROC curve of FNH and HA was 96. 1%. The critical point of the ratio of the mean elasticity of Young＇s modulus was 6. 32 by ROC curve,the sensitivity was 98. 2%,and specificity was 67. 4%. The area under the ROC curve was97. 2%. Conclusion： SWE has an important value of clinical application in diagnosis between FNH and HA.

关 键 词：剪切波超声弹性成像 杨氏模量 ROC曲线 

分 类 号：R445.1[医药卫生—影像医学与核医学]