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肝细胞癌中声辐射力脉冲定量数据与灌注CT参数的比较。

Comparison between acoustic radiation force impulse quantification data and perfusion-CT parameters in hepatocellular carcinoma.

作者信息

Esser Michael, Schneeweiß Sven, Kolb Manuel, Kurucay Mustafa, Ruff Christer, Nikolaou Konstantin, Horger Marius

机构信息

Department of Radiology, Diagnostic and Interventional Radiology, University Hospital of Tuebingen, Hoppe-Seyler-Str. 3, 72076 Tuebingen, Germany.

出版信息

Eur J Radiol. 2017 Apr;89:215-220. doi: 10.1016/j.ejrad.2017.02.014. Epub 2017 Feb 14.

Abstract

OBJECTIVE

To find out, if ultrasound elastography of hepatocellular carcinoma (HCC) can predict patterns of tumor perfusion in volume perfusion computed tomography (VPCT).

MATERIAL AND METHODS

25 consecutive patients (mean age, 68.9; range, 51-85 years) with liver cirrhosis suspected of HCC underwent VPCT and acoustic radiation force impulse (ARFI) elastography the same day. Quantitative elasticity values were registered, while blood flow (BF), blood volume (BV) and hepatic perfusion index (HPI) of the HCC lesions were calculated. Additionally, we identified histologic WHO grading, lesion size and localization. The Siemens Acuson S 3000 HELX-System with Virtual Touch™-Software and Siemens Somatom Definition Flash with Syngo software were used.

RESULTS

A total of 43 HCC lesions were assessed. Mean shear wave velocity was 2.6m/s (range, 1.1-4.3m/s). There was no significant linear correlation between the elasticity values and BF (p=0.751), BV (p=0.426) and HPI (p=0.437). However, elasticity values were higher, the larger the tumor was (p=0.008). Shear wave velocity declined with increasing distance of the HCC to the skin surface (p=0.028) and depending on liver segment. In addition, elasticity values were higher in less differentiated HCCs. This trend was not statistically significant (p=0.842).

CONCLUSION

Tissue elasticity in HCC does not correlate with the degree of tumor vascularization, but calculated values are influenced both by the tumor size and localization inside the liver.

摘要

目的

探究肝细胞癌(HCC)的超声弹性成像能否预测容积灌注计算机断层扫描(VPCT)中的肿瘤灌注模式。

材料与方法

25例疑似患有HCC的肝硬化患者(平均年龄68.9岁;范围51 - 85岁)于同一天接受了VPCT和声学辐射力脉冲(ARFI)弹性成像检查。记录定量弹性值,同时计算HCC病变的血流量(BF)、血容量(BV)和肝灌注指数(HPI)。此外,我们还确定了组织学WHO分级、病变大小和位置。使用配备了虚拟触诊™软件的西门子Acuson S 3000 HELX系统以及配备了Syngo软件的西门子Somatom Definition Flash。

结果

共评估了43个HCC病变。平均剪切波速度为2.6m/s(范围1.1 - 4.3m/s)。弹性值与BF(p = 0.751)、BV(p = 0.426)和HPI(p = 0.437)之间均无显著线性相关性。然而,肿瘤越大,弹性值越高(p = 0.008)。剪切波速度随着HCC距皮肤表面距离的增加而下降(p = 0.028),并且取决于肝段。此外,低分化HCC的弹性值更高。这一趋势无统计学意义(p = 0.842)。

结论

HCC中的组织弹性与肿瘤血管化程度无关,但计算值受肿瘤大小和肝脏内位置的影响。

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