| 摘要: |
| 目的 探讨声触诊组织定量（VTQ）技术鉴别诊断乙肝相关性小肝癌与增生结节的临床价值。方法 选取经手术或穿刺病理证实的小肝癌患者54例和增生结节患者30例，均行常规超声及VTQ检查，获得其剪切波速度（SWV），并绘制受试者工作特征（ROC）曲线进行统计学分析良恶性结节的最佳截断值，曲线下面积，敏感度，特异度，阳性预测值，阴性预测值，阳性似然比，阴性似然比等。结果 小肝癌患者的SWV值高于增生结节患者，54例小肝癌的SWV均值（3.45±1.44）m/s，95%可信区间（3.06，3.85）m/s，30例增生结节的SWV均值（1.87±0.40）m/s，95%可信区间（1.72，2.02）m/s，Kappa值为0.82，P＜0.05，显示病灶VTQ成像检测的一致性较好。诊断小肝癌的ROC曲线下面积为0.96，SWV为2.455 m/s时敏感度为90.74%，特异度为93.33%，阳性预测值96.08%，阴性预测值84.85%，阳性似然比13.61，阴性似然比0.10。结论 VTQ检查能够通过SWV反映出结节的硬度，在早期判定乙肝相关性小肝癌鉴别诊断中具有重要价值，是常规超声的有效补充。 |
| 关键词: 小肝癌 声触诊组织定量 弹性 超声 |
| DOI： |
| 投稿时间：2016-09-03修订日期：2017-03-31 |
| 基金项目:2015年度深圳市科技创新委员会科研项目，编号：JCYJ20150403101028181 |
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| The differential diagnosis value of small-hepatocellular carcinoma and dysplastic nodule associated with HBV infection by Virtual touch tissue QuantificationShi Qiu-ling Zhang Lei Dong Fa-jin Xu Jin-feng Ding Zhi-min Song Hong |
| Shi Qiuling,DongFajin |
| (Shenzhen people's hospital) |
| Abstract: |
| BSTRACT Objective To investigate the value of Virtual touch tissue Quantification (VTQ) imaging in differentiating diagnosis of small-hepatocellular carcinoma(sHCC) and dysplastic nodule(DN) associated with HBV infection. Methods Fifty-four sHCCs and 30 DNs，confirmed by Surgery or biopsy pathology were included in our study. All were examined by convention ultrasound and VTQ，the shear wave velocity(SWV) of the nodules and tissue surounding nodule were required. Receiver-operating characteristic curve(ROC) ,area under ROC curve(AUROC),sensitivity，specificity，positive predictive value，negative predictive value， Likelihood ratio，-Likelihood ratio were performed to assess the diagnostic value. Results
The SWV value of sHCC was higher than dysplastic nodule(DN), Of the 54 sHCCs, the mean SWV was [(3.45±1.44)m/s，95%CI：( 3.06，3.85)m/s], and the 30 DNs, the mean SWV was [(1.87±0.40)m/s，95%CI：(1.72，2.02)m/s]. Kappa value was 0.82, P＜0.05, The Kappa test results showed better consistency. The AUROC was 0.96，With a cut-off value of 2.455 m/s，the sensitivity，specificity，positive predictive value，negative predictive value， Likelihood ratio，-Likelihood ratio for differentiating between the benign and the malignancy nodules were 90.74%，93.33%，96.08%，84.85%，13.61，0.10，respectively. Conclusion VTQ provides the stiffness of benign and malignant nodules by SWV，which could play an important value in differentiating diagnosis of sHCC and dysplastic nodule associated with HBV infection. |
| Key words: small-hepatocellular carcinomas Virtual Touch tissue quantification(VTQ) elastography Ultrasound |
