Department of Ultrasound, Binzhou Medical University Hospital, 2 Huanghe Road, Shixi District, Binzhou 256600, China.
Department of Ultrasound, North China Medical Treatment Health Group, Fengfeng General Hospital, No.2 Gushan South Street, Fengfeng District, Handan 056200, China.
Eur J Radiol. 2022 Sep;154:110459. doi: 10.1016/j.ejrad.2022.110459. Epub 2022 Jul 29.
This prospective study aimed to compare the diagnostic accuracy of shear wave elastography (SWE) with that of shear wave dispersion (SWD) in evaluation of hepatic fibrosis in patients with hepatocellular carcinoma before resection.
A total of 210 consecutive patients with hepatocellular carcinoma (HCC) who were scheduled to undergo hepatectomy were prospectively enrolled, pre-operative SWE and SWD examinations were performed. Fibrosis staging and necroinflammatory activity were determined histopathologically according to the Scheuer standard. Multivariate linear regression analysis was used to identify factors associated with SWE and SWD values. The performance of SWE and SWD were determined by receiver operating characteristic (ROC) analysis.
Both SWE and SWD values of liver were highly correlated with liver fibrosis stage and necroinflammatory activity (p < 0.05). Both SWE and SWD values were significantly different among the patients with different stages of liver fibrosis (p < 0.001). ROC analysis revealed that SWE that predicted substantial fibrosis (S ≥ 2), severe fibrosis (S ≥ 3) and cirrhosis (S = 4) were 0.895, 0.877 and 0.854, the SWD that predicted substantial fibrosis (S ≥ 2), severe fibrosis (S ≥ 3) and cirrhosis (S = 4) were 0.857, 0.815 and 0.791. SWE had better diagnostic performance than SWD in predicting severe fibrosis (S ≥ 3) and cirrhosis (S = 4).
Both SWE and SWD are useful, accurate and non-invasive methods for evaluating hepatic fibrosis in patients with hepatocellular carcinoma adapted to hepatectomy, SWE is a more accurate imaging modality than SWD in predicting severe fibrosis (S ≥ 3) and cirrhosis (S = 4).
本前瞻性研究旨在比较剪切波弹性成像（SWE）与剪切波分散度（SWD）在评估肝癌患者肝切除术前肝纤维化中的诊断准确性。
前瞻性纳入 210 例拟行肝切除术的肝细胞癌（HCC）患者，术前进行 SWE 和 SWD 检查。根据 Scheuer 标准，组织病理学确定纤维化分期和坏死性炎症活动度。采用多元线性回归分析确定与 SWE 和 SWD 值相关的因素。采用受试者工作特征（ROC）分析确定 SWE 和 SWD 的性能。
肝脏 SWE 和 SWD 值与肝纤维化分期和坏死性炎症活动度高度相关（p<0.05）。不同纤维化分期患者的 SWE 和 SWD 值差异均有统计学意义（p<0.001）。ROC 分析显示，SWE 预测显著纤维化（S≥2）、严重纤维化（S≥3）和肝硬化（S=4）的曲线下面积分别为 0.895、0.877 和 0.854，SWD 预测显著纤维化（S≥2）、严重纤维化（S≥3）和肝硬化（S=4）的曲线下面积分别为 0.857、0.815 和 0.791。SWE 在预测严重纤维化（S≥3）和肝硬化（S=4）方面的诊断性能优于 SWD。
SWE 和 SWD 均为适用于肝切除术的评估肝癌患者肝纤维化的有用、准确、非侵入性方法，SWE 在预测严重纤维化（S≥3）和肝硬化（S=4）方面比 SWD 更准确。
