超声实时组织弹性成像在肝脏局灶性结节性增生与肝腺瘤鉴别诊断中的应用价值.pdf

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1、第-~gN大学学报2014年5月第35卷第5期http：／／www．ajsmmu．c1"1·524·AcademicJournalofSecondMilitaryMedicalUniversity，May2014，Vo1．35，No．5DOI：10．3724／SP．J．1008．2014．00524·论著·超声实时组织弹性成像在肝脏局灶性结节性增生与肝腺瘤鉴别诊断中的应用价值洪峻峰，郭佳¨，梁丽琼，冀建峰1．第二军医大学东方肝胆外科医院超声科，上海2004382．解放军94医院超声科，南昌330002[摘要]目的探讨超声实时组织弹性成像(real—timetissu

2、eelastography，RTE)在肝脏局灶性结节性增生(focalnodu—larhyperplasia，FNH)与肝腺瘤(hepatocellularadenoma，HCA)鉴别诊断中的应用价值。方法回顾性分析经术后病理证实的2O例FNH(22个病灶)和8例HCA(9个病灶)患者的超声RTE检查资料，采用5分法对弹性图像进行评分并测量其应变率比值(strainratio，SR)，比较FNH和HCA弹性图像评分和SR的差异。结果FNH弹性图像评分以3～4分为主(18／22，81．8)，而HCA评分以1分为主(5／9，55．6)，两者的评分差异存在统计学意义(P—

3、o．0002)；FNH和HCA的应变率比值分别为7．47±4．53、1．64±0．88，差异具有统计学意义(P

4、JularadenomaHONGJun-feng，GUOJia，LIANGLi—qiong，JIJian—feng1．DepartmentofUltrasonography，EasternHepatobiliarySurgeryHospital，SecondMilitaryMedicalUniversity，Shanghai200438，China2．DepartmentofU1trasonography，No．94HospitalofPLA，Nanchang330002，Jiangxi，China[Abstract]0bjectiveToinvestigateth

5、evalueofreal—timetissueelastography(RTE)inthedifferentialdiagnosisoffocalnodularhyperplasia(FNH)andhepatocellularadenoma(HCA)．MethodsTheRTEdataof20patientswithpathologicallyprovenFNH(22lesions)and8patientswithHCA(9lesions)wereretrospectivelyanalyzed．TheRTEdatawereevaluatedbyscores(grad

6、es1-5)andthestrainratios(SR)ofthenoduleswerecalculatedandcomparedbetweenthetwogroups．ResultsMostFNHlesionshadagradeof3-4(18／22，81．8)onelastography，whilemostlesionsofHCAhadagradeof1(5／9，55．6)onelastography，withsignificantdifferencefoundbetweenthetwogroups(P一0．0002)．ThestrainratioofFNHwa

7、ssignificantlyhigherthanthatofHCA(7．47-_-+4．53vs1．64_4-0．88，P％0．0001)．ConclusionThestiffnessofFNHinRTEisnotablyhigherthanthatofHCA，indicatingRTEmaybeasupplementarytoroutineultrasonicexamination，whichmaybehelpfulfordifferentialdiagnosisofFNHandHCA．[Keywords]ultrasonography；elasticityi