目的:探讨声辐射力触诊(ARFI)组织定量(VTQ)技术对肝脏局灶性病变良恶性的鉴别诊断价值。方法对92个肝局灶性病变进行VTQ检查,测量并记录其横向剪切波速度(SWV),比较良恶性肝局灶性病变间SWV的差异,并确定截断值。采用受试者工作特征曲线(ROC)评价VTQ技术鉴别肝局灶性病变良恶性的价值。结果92个局灶性病变包括41(45.0%)个恶性肿瘤和51(55.0%)个良性病灶,恶性病变组与良性病变组SWV比较有显著性差异[(3.66±1.65)m/s vs.(1.57±0.81)m/s,P<0.001)]。鉴别良恶性病变的ROC曲线下面积(AUROC)为0.846(95% CI:0.765-0.927,P<0.001)。以SWV=2.11 m/s作为截断值,鉴别肝脏局灶性病变良恶性的灵敏度、特异度、阳性预测值和阴性预测值分别为82.9%,76.5%,73.9%和84.8%。结论 ARFI VTQ技术可定量反映组织弹性特征,有助于鉴别肝局灶性病变的良恶性。
Objective To explore the value of virtual touch tissue quantification (VTQ) of acoustic radiation force impulse elastography (ARFI) in differentiating focal liver lesions (FLLs). Methods A total of 92 patients with 92 FLLs were included. VTQ measurement was performed for each lesion and the shear wave velocity (SWV) was measured. The difference in SWV between malignant and benign FLLs was evaluated. Receiver operating characteristic (ROC) curve was plotted to evaluate the diagnostic performance. Results Among 92 lesions 41 (45.0%) were malignant and 51 (55.0%) were benign. Significant in SWV was found between malignant and benign FLLs [(3.66±1.65) m/s vs. (1.57±0.81) m/s, P〈0.001]. The area under ROC curve was 0.846 (95%CI: 0.765-0.927, P〈0.001) for SWV and the cutoff was 2.11 m/s. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were 82.9%, 76.5%, 73.9%and 84.8%respectively. Conclusion ARFI VTQ provides quantitative information about the FLL stiffness and is helpful in the differential diagnosis between malignant and benign FLLs.