超声弹性成像在鉴别大网膜病变性质中的应用价值  

Application value of ultrasonic elastography in distinguishing the nature of greater omentum lesions

作　　者：陈治光 王学梅[1] 汪惠鹏 张义侠[1] 翟齐西[1] 陈波[1] Chen Zhiguang;Wang Xuemei;Wang Huipeng;Zhang Yixia;Zhai Qixi;Chen Bo(Department of Ultrasound,First Affiliated Hospital of China Medical University,Shenyang 110001,China)

机构地区：[1]中国医科大学附属第一医院超声科,沈阳110001

出　　处：《中华超声影像学杂志》2020年第12期1049-1053,共5页Chinese Journal of Ultrasonography

摘　　要：目的探讨实时剪切波弹性成像和助力式弹性成像单独及联合应用在大网膜良恶性病变鉴别诊断中的价值。方法回顾性分析2018年10月至2020年1月中国医科大学附属第一医院128例大网膜病变患者的弹性声像图,根据病理结果分为网膜良性病变组和网膜恶性病变组,分别统计两组患者年龄、性别、网膜厚度以及杨氏模量值平均值、最小值、最大值(Emean、Emin、Emax)和弹性评分(1~4分),对两种弹性成像单独及联合应用时诊断网膜恶性病变的效能进行统计分析,并建立ROC曲线评价其诊断效能。结果网膜良恶性病变组杨氏模量值Emean、Emin、Emax差异有统计学意义(均P<0.05),Emean-ROC曲线下面积为0.91,以Emean≥28.94 kPa作为诊断网膜恶性病变的界点时,剪切波弹性成像诊断的敏感性、特异性及准确性分别为91.36%、82.99%、88.28%;网膜良恶性病变的弹性评分差异有统计学意义(P<0.05),弹性评分ROC曲线下面积为0.83,以弹性评分≥3分作为诊断网膜恶性病变的界点时,助力式弹性成像诊断的敏感性、特异性及准确性分别为85.18%、91.49%、87.50%。两种弹性成像技术联合应用后诊断网膜恶性病变的敏感性、特异性和准确性分别为93.83%、80.85%、89.06%。结论两种弹性成像技术在网膜良恶性病变的鉴别诊断中各有优缺点,实时剪切波弹性成像在鉴别网膜病变性质时有较高的敏感性,而助力式弹性成像有较高的特异性,且真实性相对较好,两者联合应用也有较高的敏感性及准确性。Objective To investigate the values of shear wave elastography(SWE)and real-time tissue elastography(RTE)used alone or in combination in the differential diagnosis of benign and malignant lesions of omentum.Methods From October 2018 to January 2020,the elastosonography of 128 patients with greater omental lesions who were treated in the First Affiliated Hospital of China Medical University were retrospectively analyzed.According to the pathological results,omental diseases were divided into benign group and malignant group.The age,gender,omental thickness,Young′s modulus of SWE(Emean,Emin,Emax)and elasticity score of RTE(1 to 4)of the two groups were calculated respectively.The diagnostic efficacies of the two kinds of elastosonography in the diagnosis of omental malignant lesions were statistically analyzed when they were used alone or in combination,and ROC curve was established to evaluate the diagnostic efficacies.Results The differences of Emean,Emin and Emax in benign and malignant omental lesions were statistically significant(P<0.05).The AUC of Emean was 0.91.The sensitivity,specificity and accuracy of SWE were 91.36%,82.99%and 88.28%respectively when Emean≥28.9 kPa was taken as the boundary point for diagnosing omental malignant lesions.The difference of elasticity score between benign and malignant lesions of omentum was statistically significant(P<0.05).The AUC of elasticity score was 0.83,and the sensitivity,specificity and accuracy of elasticity score were 85.18%,91.49%and 87.50%respectively,when elasticity score≥3 points was taken as the boundary point for diagnosing omental malignant lesions.The sensitivity,specificity and accuracy of the combined application of the two elastosonography in the diagnosis of omental malignant lesions were 93.83%,80.85%and 89.06%,respectively.Conclusions In the differential diagnosis of omental benign and malignant lesions,the two elastosonography have their own advantages and disadvantages.The SWE has a higher sensitivity,while the RTE has a higher specificity,

关 键 词：实时剪切波弹性成像 弹性评分法 大网膜病变 超声弹性 

分 类 号：R445.1[医药卫生—影像医学与核医学] R735.4[医药卫生—诊断学]