Department of Radiology, Dicle University, School of Medical Science, Diyarbakir, Turkey.
Radiol Med. 2015 Mar;120(3):296-303. doi: 10.1007/s11547-014-0443-7. Epub 2014 Aug 6.
The purpose of this preliminary study was to prospectively evaluate the diagnostic performance of acoustic radiation force impulse (ARFI) imaging for differentiating benign lesions from malignant renal tumours.
Sixty patients with renal lesions were enrolled in the study; mean patient age was 49.52 ± 20.46 years (range 1-83 years) and patients included 30 men and 30 women. Lesions were categorised as benign (n = 19), malignant (n = 36) and infectious (n = 5) in origin. The shear wave velocities (SWVs) of the tumours and the intact parenchyma were determined by ARFI quantification, and the differences in the SWVs were compared among groups. The final diagnoses were determined via pathologic (n = 33), clinical (n = 13) and imaging findings (n = 14). The SWV values of the renal tumours were analysed according to the final diagnoses.
The mean SWV value of the normal renal parenchyma was significantly different from that of all other lesions (p < 0.01). There was a significant difference between the SWV values of benign renal lesions including haematomas and the malignant renal lesions (p = 0.033). However, the SWV values of the infectious lesions and leiomyoma corresponded well with the malignant lesions. A Receiver operating characteristic (ROC) analysis demonstrated a cut-off value of 2.34 m/s between benign and malignant lesions, while sensitivity and specificity were determined to be 88 and 54 %, respectively.
ARFI elastography with ARFI quantification may be useful for differentiating benign renal lesions from malignant renal tumours.
本初步研究旨在前瞻性评估声辐射力脉冲(ARFI)成像在鉴别良恶性肾肿瘤中的诊断性能。
本研究纳入 60 例肾病变患者;患者平均年龄为 49.52 ± 20.46 岁(1-83 岁),包括 30 名男性和 30 名女性。病变分为良性(n = 19)、恶性(n = 36)和感染性(n = 5)来源。通过 ARFI 定量法测定肿瘤和完整肾实质的剪切波速度(SWV),并比较各组之间 SWV 的差异。最终诊断通过病理(n = 33)、临床(n = 13)和影像学检查(n = 14)确定。根据最终诊断分析肾肿瘤的 SWV 值。
正常肾实质的平均 SWV 值与所有其他病变明显不同(p < 0.01)。良性肾病变(包括血肿)与恶性肾病变的 SWV 值有显著差异(p = 0.033)。然而,感染性病变和平滑肌瘤的 SWV 值与恶性病变相符。受试者工作特征(ROC)分析显示,良性和恶性病变之间的 SWV 值截断值为 2.34 m/s,敏感性和特异性分别为 88 和 54%。
ARFI 弹性成像结合 ARFI 定量法可能有助于鉴别良恶性肾肿瘤。