【摘要】 目的:探讨声脉冲辐射成像技术(Acoustic radiation force impulse ARFI)鉴别诊断肝脏局灶性病变良恶性的临床应用价值。方法:应用ARFI技术对85例患者85个肝脏肿块进行声触诊组织成像(Virtual touch tissue imaging,VTI)及声触诊组织量化(Virtual touch tissue quantification,VTQ)检查,VTI对局灶性病变进行评分,VTQ测量病灶内部剪切波速度(Shear wave velocity,SWV),与术后病理结果对照,分析肝脏局灶性病变良、恶性组间的差异。结果:VTI评分及VTQ技术在肝脏局灶性良恶性组间比较差异有统计学意义(<0.001)。ROC曲线下面积分别为0.849±0.043[95%CI(0.766,0.933),=0.000]、0.911±0.033[95%CI(0.846,0.976),=0.000]。SWV以2.43m/s作为肝脏恶性病灶的诊断截点,敏感性为82.2%,特异性为86.1%;VTI评分3分作为诊断肝脏恶性病灶的截点,敏感性为84.4%,特异性为77.8%。联合VTI评分及VTQ诊断的敏感性、特异性及准确性分别为84.4%、86.1%、81.2%。结论:VTI评分和VTQ技术有助于肝脏局灶性病变的良恶性鉴别诊断,联合应用诊断准确性优于两者单独使用。更多还原

【Abstract】 Objective: To explore the clinical application value of Acoustic radiation force impulse elastography in the differential diagnosis of benign and malignant focal lesions of the liver.Methods:Eighty-five patients with 85 masses(39 malignant,46 benign)were studied with conventional ultrasound examination firstly,and then Acoustic radiation force impulse(ARFI) technology.Organization hardness score was evaluated by virtual touch tissue imaging(VTI), the shear wave velocity(SMV) of the tumors was measured by virtual touch tissue quantification(VTQ).Measured result were compared with pathological results,drawed the ROC curve find the cutoff value point of VTI and VTQ to predict liver cancer.The difference between benign and malignant focal lesions of the liver was analyzed.Results:VTI scores and VTQ was significant difference between benign and malignant groups( <0.001).Areas of ROC curve of VTI scores and VTQ was sepreately 0.849±0.043[95%CI(0.766,0.933),=0.000]、0.911±0.033 [95%CI(0.846,0.976), =0.000].The cut off value of VTI scores and SMV in diagnosis of malignant masses were 3 scores and 2.43m/s, sensitivity and specificity of diagnosing focal lesions of the liver of 3 scores were 84.4%,77.8%, 2.43m/s were 82.2%,86.1%.Sensitivity,specificity and accuracy of the combination of VTI scores and VTQ were 84.4%,86.1%,81.2%.Conclusions:ARFI provides qualitative and quantitative elasticity measurements of focal lesions of the liver which can help improve the differentiate benign from malignant focal lesions.the diagnostic performance is improved when VTI scores combined with VTQ.更多还原