摘要
目的探讨超微血管成像(SMI)联合声触诊组织量化(VTQ)参数鉴别诊断肝脏占位性病变良恶性的价值。方法选择2020年1月—2023年7月本院收治的86例肝脏占位性病变患者为研究对象,于入院后对患者进行SMI、VTQ检查(及肝穿刺活检,以活检结果为“金标准”,将患者分为恶性组与良性组两组。比较不同组别SMI检查指标(病变血流分级)、VTQ检查指标[病灶内部剪切波速度(SWV)、周边组织SWV],并绘制受试者工作特征(ROC)曲线,评估VTQ参数诊断肝脏占位性病变良恶性的价值,采用一致性Kappa检验评价SMI、VTQ参数单独及联合诊断肝脏占位性病变良恶性与金标准结果的一致性。结果86例肝脏占位性病变患者经肝穿刺活检共检出38例恶性病变,占比44.19%;恶性组SMI检查病变血流分级高于良性组,差异有统计学意义(P<0.05);恶性组VTQ检查病灶内部SWV、周边组织SWV均高于良性组,差异有统计学意义(P<0.05);绘制ROC曲线结果显示,VTQ参数病灶内部SWV、周边组织SWV诊断肝脏占位性病变良恶性的曲线下面积(AUC)均>0.7,最佳截断值分别为2.35 m/s、1.55 m/s;以ROC曲线结果定义VTQ参数诊断恶性肝脏占位性病变的标准,以SMI病变血流分级为2~3级为恶性肝脏占位性病变进行一致性检验,结果表明,二者联合诊断与金标准的一致性更高。结论SMI联合VTQ参数对肝脏占位性病变良恶性有较高的鉴别诊断价值。
Objective To investigate the value of superb microvascular imaging(SMI)combined with virtual touch tissue quantification(VTQ)parameters in the differential diagnosis of benign and malignant liver space-occupying lesions.Methods 86 patients with liver space-occupying lesions who were admitted to the fifth people's hospital of Anyang city from January 2020 to July 2023 were enrolled as study subjects.After admission,SMI,VTQ examination and liver biopsy were performed on the patients.The patients were divided into the malignant group and the benign group according to biopsy results as the“gold standard”.The SMI examination indexes(blood flow grading of lesions)and VTQ examination indexes[shear wave velocity(SWV)in lesions and SWV in surrounding tissues]were compared between different groups,and the receiver operating characteristic(ROC)curve was drawn to evaluate the value of VTQ parameters in the diagnosis of benign and malignant liver space-occupying lesions.The consistency Kappa test was used to evaluate the consistency of SMI,VTQ parameters alone and in combination with gold standard results in the diagnosis of benign and malignant liver space-occupying lesions.Results A total of 38 malignant lesions were detected through liver biopsy in 86 patients with liver space-occupying lesions,accounting for 44.19%.The blood flow grading of SMI examination in the malignant group was higher than that of the benign group,with statistical significant differences(P<0.05).The SWV inside the lesion and the SWV of the surrounding tissue in the malignant group were higher than those in the benign group by VTQ,with statistical significant differences(P<0.05).The results of ROC curve showed that the area under the curve(AUC)of VTQ parameters internal lesion SWV and peripheral tissue SWV in the diagnosis of benign and malignant liver space-occupying lesions were over 0.7,and the optimal cut-off values were 2.35 m/s and 1.55 m/s,respectively.The results of ROC curve were used to define the criteria of VTQ parameters in the diagnosis of malignant liver occupying lesions.The consistency test was carried out with SMI lesion blood flow grade of 2-3 as malignant liver occupying lesions.The results showed that the combined diagnosis of the two was more consistent with the gold standard.Conclusions SMI combined with VTQ parameters has a high value in the differential diagnosis of benign and malignant liver lesions.
作者
王希英
王树伟
Wang Xiying;Wang Shuwei(Color Ultrasound Room,the Fifth People's Hospital of Anyang,Anyang,Henan 455000,China;Color Ultrasound Room,Anyang Hospital of Traditional Chinese Medicine,Anyang,Henan 455000,China)
出处
《齐齐哈尔医学院学报》
2024年第3期252-255,共4页
Journal of Qiqihar Medical University
关键词
肝脏占位性病变
超微血管成像
声触诊组织量化
鉴别诊断
Liver space-occupying lesions
Superb microvascular imaging
Virtual touch tissue quantification
Differential diagnosis
