Wang Kun, Zhang Shuchen, Zhou Wenyan, Wen Li, Zhang Shanshan, Yu Dong
Department of Ultrasound, The Affiliated Hospital of Binzhou Medical University, Binzhou, China.
Department of Ultrasound, Yancheng City, No. 1 People' s Hospital, Yancheng, China.
J Ultrasound Med. 2023 Apr;42(4):797-807. doi: 10.1002/jum.16029. Epub 2022 Jun 22.
This study aimed to compare the diagnostic accuracy of shear wave elastography (SWE) with that of shear wave dispersion (SWD) in evaluation of hepatic parenchyma in patients with liver tumors before resection.
A total of 174 patients with liver tumors were prospectively enrolled. SWE and SWD examinations were performed. Fibrosis stage and necroinflammatory activity were determined histopathologically according to the Scheuer standard. We compared the diagnostic accuracy of SWE and SWD.
Both SWE and SWD values of the liver were highly correlated with liver fibrosis stage (P < .05, respectively). Both SWE and SWD values of the liver were moderately correlated with necroinflammatory activity (P < .05, respectively). Both SWE and SWD values of the liver were not correlated with steatosis (P > .05, respectively). Both SWE and SWD values were significantly different among the patients with different stages of liver fibrosis (P < .001, respectively). The area under the receiver operating characteristic (ROC) curve of SWE value was 0.982, 0.977, 0.969, and 0.984 for predicting S ≥ 1, S ≥ 2, S ≥ 3, and S = 4, respectively. The optimal cutoff SWE values were 6.9, 7.9, 8.7, and 10.6 kPa for S ≥ 1, S ≥ 2, S ≥ 3, and S = 4, respectively. The area under the ROC curve of SWD value was 0.967, 0.960, 0.925, and 0.954 for predicting S ≥ 1, S ≥ 2, S ≥ 3, and S = 4, respectively. The optimal cutoff SWD values were 11.2, 12.0, 13.2, and 16.0 m/s/kHz for S ≥ 1, S ≥ 2, S ≥ 3, and S = 4, respectively.
SWE and SWD could be noninvasive and accurate for predicting the stage of liver fibrosis in patients with liver tumors before surgery. SWE was more accurate than SWD in predicting severe fibrosis (S ≥ 3) and cirrhosis (S = 4).
本研究旨在比较剪切波弹性成像（SWE）与剪切波频散（SWD）在评估肝肿瘤患者术前肝实质方面的诊断准确性。
前瞻性纳入174例肝肿瘤患者。进行SWE和SWD检查。根据Scheuer标准通过组织病理学确定纤维化阶段和坏死性炎症活动度。我们比较了SWE和SWD的诊断准确性。
肝脏的SWE和SWD值均与肝纤维化阶段高度相关（分别为P < 0.05）。肝脏的SWE和SWD值均与坏死性炎症活动度中度相关（分别为P < 0.05）。肝脏的SWE和SWD值均与脂肪变性无关（分别为P > 0.05）。不同肝纤维化阶段患者的SWE和SWD值均有显著差异（分别为P < 0.001）。SWE值预测S≥1、S≥2、S≥3和S = 4时，受试者操作特征（ROC）曲线下面积分别为0.982、0.977、0.969和0.984。S≥1、S≥2、S≥3和S = 4时，SWE的最佳截断值分别为6.9、7.9、8.7和10.6 kPa。SWD值预测S≥1、S≥2、S≥3和S = 4时，ROC曲线下面积分别为0.967、0.960、0.925和0.954。S≥1、S≥2、S≥3和S = 4时，SWD的最佳截断值分别为11.2、12.0、13.2和16.0 m/s/kHz。
SWE和SWD可无创且准确地预测肝肿瘤患者术前肝纤维化阶段。在预测严重纤维化（S≥3）和肝硬化（S = 4）方面，SWE比SWD更准确。
