声触诊组织量化技术在肝脏小肿块良恶性鉴别诊断中的价值

摘要

目的 探讨声触诊组织量化技术(VTQ)在肝脏小肿块(≤20 mm)良恶性鉴别诊断中的价值.方法 选取56例肝脏实质占位患者(74个肝脏小肿块),采用VTQ分别测量肿块内部及其对应背景区肝实质组织的剪切波速度(SWV).以病理检查或临床诊断结果作为诊断标准,采用受试者工作特征(ROC)曲线评价VTQ鉴别诊断肝脏小肿块良恶性的价值.结果 经病理诊断74个小肿块中恶性病灶37个,良性病灶37个.良性肿块内部的SWV值为(1.42±0.54)m/s,低于恶性肿块的(2.45±0.84)m/s(P<0.05).VTQ鉴别诊断肝脏小肿块良恶性的ROC曲线下面积为0.854,以SWV=1.91 m/s作为诊断临界值,VTQ诊断肝脏恶性小肿块的敏感性为81.1%,特异性为89.2%,阳性预测值为88.25%,阴性预测值为82.52%.结论 VTQ对肝脏小肿块的良恶性鉴别诊断有一定的价值.%Objce tive To explore the value of virtual touch tissue quantification ( VTQ) in the differential diagnosis of benign and malignant hepatic nodules .Methods Fifty-six patients with solid hepatic space-occupying lesions involving 74 hepatic nodules were enrolled.VTQ was used to detect the inside of nodule and the liver parenchyma of its corresponding region of background for shear wave velocity(SWV).Using the pathological results or clinical diagnosis as the diagnostic standard ,receiver operating characteristic ( ROC) curve was adopted to evaluating the value of VTA in the differential diagnosis of benign and malignant hepatic nodules .Results The pathological result showed that there were 37 malignant foci and 37 benign foci out of 74 nodules .SWV of the inside of benign nodule was lower than that of the malignants(1.42 ±0.54 m/s vs 2.45 ±0.84 m/s;P<0.05).The area under ROC curve of VTQ for differential diagnosis of benign and malignant hepatic nodules was 0.854 with the diagnostic threshold of SWV equal to 1.91 m/s,and the sensitivity, specificity,positive predictive value and negative predictive value of VTQ for diagnosis of malignant nodules were 81.1%,89.2%,88.25%and 82.52%respectively .Conclusion VTQ is valuable in the differential diagnosis of benign and malignant hepatic nodules .