两种不同弹性成像技术在肝脏肿瘤良恶性鉴别诊断中的对比分析  

The comparative analysis of two different ultrasoud elastography in the differential diagnosis of benign and malignant liver tumors

作　　者：肖静子 肖萤[1] 熊烟绫 Xiao Jingzi; Xiao Ying; Xiong Yanling(Department of Ultrasonography, Xiangya Hospital of Central South University, Changsha 410008, Chin)

机构地区：[1]中南大学湘雅医院超声影像科,长沙410008

出　　处：《中国医师杂志》2018年第7期1006-1009,共4页Journal of Chinese Physician

基　　金：湖南省2013年产业研发项目([2013]1132)~~

摘　　要：目的探讨实时剪切波弹性成像(SWE)与弹性应变率比值(SR)鉴别诊断肝脏肿瘤良恶性的应用价值。方法选取2017年3月至8月来本院就诊的68例肝脏患者,共70个肝脏肿瘤病灶,SWE参数为最大实时剪切波速度值(Vmax)、平均实时剪切波速度值(Vmean)、病灶/周围肝组织实时剪切波速度弹性比(Vratio)。构建出SWE、SR鉴别诊断肝脏肿瘤良恶性的受试者工作特征(ROC)曲线,算出二者的ROC曲线下面积(AUC)及最佳临界点,各结果之间AUC的比较采用De Long法。计算AUC最大的SWE参数,并分别计算其和SR法的灵敏度、特异度、准确性,其之间准确性的比较采用McNemar检验,P <0. 05为差异有统计学意义。结果 SR与SWE参数Vmax、Vmean、及Vratio鉴别诊断肝脏良恶性肿瘤ROC的AUC分别为0. 948、0. 868、0. 918、0.956,差异均无统计学意义(P>0.05)。SR法的灵敏度、特异度、准确性分别为92.73%、93.33%、92.86%,Vratio在SWE各参数中的AUC最大,Vratio的灵敏度、特异度、准确性分别为94. 56%、100. 00%、95. 71%,二者准确性比较差异无统计学意义(P>0.05)。结论应用SWE和SR法鉴别诊断肝脏肿瘤良恶性均有较高的诊断价值,为肝脏肿瘤病灶的鉴别诊断提供了新的方法,且两者的诊断价值相当。Objective To compare the diagnostic performances of real time of shear wave elastogra- phy （SWE） and strain ratio （SR） in differentiating benign and malignant liver tumors. Methods From March 2017 to August 2017,68 patients with 70 lesions were examined with SR and SWE respectively, the parameters of SWE were maximum real-time shear wave velocity （Vmax） , average real-time shear wave ve- locity （Vmean） and real-time shear wave velocity elasticity ratio of lesion/peripheral liver tissue （Vratio）. The receiver operating characteristic （ROC） curve of SWE and SR parameters were plotted to assess the value in distinguishing benign and malignant liver tumors. The results were compared using the area under the ROC curve （AUC）. The sensitivity, specificity, accuracy of SWE and SR were calculated, The accura- cy of the parameters with the largest AUC were compared between SWE and SR by McNemar test in differen- tiating focal liver lesions. Results The AUC of SR,Vmax,Vmean and Vratio were 0. 948, 0. 868, 0. 918 and 0. 956 respectively. The comparison of AUC reveals no significant difference between them. The sensi- tivity, specificity, accuracy of SR in differentiating benign and malignant liver tumors were 92. 73% , 93.33% , 92. 86% respectively （P 〉 0. 05 ）. The SWE parameter with the largest AUC was Vratio. The sensitivity, specificity, accuracy of Vratio was 94. 56% , 100.00% , 95.71%, respectively. The accuracy of Vratio and SR in differentiating benign and malignant liver tumors showed no significant difference （P 〉 0. 05）. Conclusions The application of SWE and SR in the differential diagnosis of benign and malignant liver tumors is of high diagnostic value. They provide a new method for the differential diagnosis of liver tumor lesions, and the diagnostic value of both of them is equivalent.

关 键 词：肝肿瘤/超声检查 弹性成像技术 诊断 鉴别 

分 类 号：R445.1[医药卫生—影像医学与核医学] R735.7[医药卫生—诊断学]