Ghiuchici Ana-Maria, Sporea Ioan, Dănilă Mirela, Șirli Roxana, Moga Tudor, Bende Felix, Popescu Alina
Department of Gastroenterology and Hepatology, "Victor Babeș" University of Medicine and Pharmacy, 300041 Timișoara, Romania.
J Clin Med. 2021 Apr 15;10(8):1710. doi: 10.3390/jcm10081710.
Elastography can provide information regarding tissue stiffness (TS). This study aimed to analyze the elastographic features of hepatocellular carcinoma (HCC) and the factors that influence intratumoral elastographic variability in patients with liver cirrhosis.
This prospective study included 115 patients with liver cirrhosis and hepatocellular carcinoma evaluated between June 2016-November 2019. A total of 88 HCC nodules visualized in conventional abdominal ultrasound (US) met the inclusion criteria and underwent elastographic evaluation. Elastographic measurements (EM) were performed in HCC and liver parenchyma using VTQ (Virtual Touch Quantification), a point shear wave elastography (pSWE) technique. In all patients, we performed contrast-enhanced ultrasound (CEUS), and the final diagnosis of HCC was established by contrast-enhanced-CT or contrast-enhanced-MRI.
The mean VTQ values in HCCs were 2.16 ± 0.75 m/s. TS was significantly lower in HCCs than in the surrounding liver parenchyma 2.16 ± 0.75 m/s vs. 2.78 ± 0.92 ( < 0.001). We did not find significant differences between the first five and the last five EM, and the intra-observer reproducibility was excellent ICC: 0.902 (95% CI: 0.87-0.950). However, the tumor size, heterogeneity, and depth correlated with higher intralesional stiffness variability ( < 0.001).
VTQ brings additional information for HCC characterization. Intra-observer reproducibility for both HCC and liver parenchyma was excellent. Knowing the stiffness of HCC's might endorse an algorithm-based approach towards focal liver lesions (FLLs) in liver cirrhosis.
弹性成像可提供有关组织硬度（TS）的信息。本研究旨在分析肝细胞癌（HCC）的弹性成像特征以及影响肝硬化患者肿瘤内弹性成像变异性的因素。
这项前瞻性研究纳入了2016年6月至2019年11月期间评估的115例肝硬化合并肝细胞癌患者。在常规腹部超声（US）中可视化的总共88个HCC结节符合纳入标准并接受了弹性成像评估。使用点剪切波弹性成像（pSWE）技术虚拟触诊定量（VTQ）对HCC和肝实质进行弹性成像测量（EM）。所有患者均接受了超声造影（CEUS），HCC的最终诊断通过增强CT或增强MRI确定。
HCC的平均VTQ值为2.16±0.75 m/s。HCC的TS明显低于周围肝实质，分别为2.16±0.75 m/s和2.78±0.92（<0.001）。我们未发现前五次和后五次EM之间存在显著差异，且观察者内重复性极佳，ICC：0.902（95%CI：0.87 - 0.950）。然而，肿瘤大小、异质性和深度与更高的瘤内硬度变异性相关（<0.001）。
VTQ为HCC的特征描述提供了额外信息。HCC和肝实质的观察者内重复性均极佳。了解HCC的硬度可能支持对肝硬化中肝脏局灶性病变（FLLs）采用基于算法的方法。
