比较实时超声弹性成像与声触诊组织定性弹性成像诊断肝局灶性病变

目的比较实时超声弹性成像(RTE)与声触诊定性弹性成像(VTI)在肝局灶性病变诊断中的价值及二者诊断的一致性。方法对44例肝结节患者(共54个结节)分别进行RTE及VTI检查。对弹性图像分别进行评分,并评价结节硬度。对照临床诊断结果,分别计算RTE和VTI的敏感度、特异度、准确率、阳性预测值和阴性预测值,并绘制ROC曲线,计算曲线下面积。采用χ2检验比较两种检查方法的差异。结果 RTE诊断肝脏恶性结节的敏感度、特异度、准确率、阳性预测值、阴性预测值分别为81.82%(27/33)、71.43%(15/21)、77.78%(42/54)、81.82%(27/33)、71.43%(15/21),VTI分别为72.73%(24/33)、71.43%(15/21)、72.22%(39/54)、80.00%(24/30)、62.50%(15/24)。RTE和VTI的曲线下面积分别为0.766和0.722(Z=0.45,P=0.3264),两种弹性成像方法均具有一定诊断价值。RTE和VTI对同一病灶的诊断一致性较好(P>0.05)。结论RTE与VTI对肝内良恶性局灶性病变具有较好的诊断价值,且具有较高的一致性。

Comparison on real-time elastography and virtual touch tissue imaging in diagnosis of focal hepatic lesions

Objective To evaluate real-time elastography (RTE) and virtual touch tissue imaging (VTI) in differentiating benign and malignant focal liver lesions, and to observe the consistency of these two methods. Methods Forty-four patients with 54 focal liver lesions underwent RTE and VTI. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value were calculated. ROC curves were drawn and areas under curve (AUC) were calculated. Chi-square test was used to testify the consistency of two different elastography methods. Results The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of RTE in diagnosis of malignant hepatic lesions was 81.82% (27/33), 71.43% (15/21), 77.78% (42/54), 81.82% (27/33), and 71.43% (15/21), respectively, and for VTI was 72.73% (24/33), 71.43% (15/21), 72.22% (39/54), 80.00% (24/30), and 62.50% (15/24), respectively. AUC was 0.766 and 0.722 for RTE and VTI (Z=0.45, P=0.3264), and two methods both had some diagnostic value. RTE and VTI had the same outcome for most lesions. Conclusion RTE and VTI may help for diagnosing benign and malignant focal liver lesions, and have good consistency.