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目的探讨超声实时组织弹性成像(real-time tissue elastography,RTE)在肝脏局灶性结节性增生(focal nodular hyperplasia,FNH)与肝腺瘤(hepatocellular adenoma,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20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(strain ratio,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=0.000 2);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<0.000 1)。结论超声RTE显示FNH硬度明显高于HCA,是对常规超声的有力补充,有助于两者的鉴别诊断。
Objective To investigate the value of real-time tissue elastography (RTE) in the differential diagnosis of focal nodular hyperplasia (FNH) and hepatocellular adenoma (HCA). Methods Twenty patients with FNH (22 lesions) and 8 patients with HCA (9 lesions) confirmed by postoperative pathology were retrospectively analyzed. The elasticity was graded by 5-point method and the ratio of strain rate ( strain ratio, SR) was used to compare the difference between FNH and HCA elastic image score and SR. Results The scores of FNH elastic images were mainly 3 to 4 (18/22, 81.8%), while HCA scores were mainly 1 (5 / 9,55.6%), the difference between the two groups was statistically significant (P = 0.000 2). The strain rate ratios of FNH and HCA were 7.47 ± 4.53 and 1.64 ± 0.88, respectively, with statistical significance (P <0.000 1). Conclusion Ultrasound RTE shows that FNH hardness is significantly higher than that of HCA, which is a powerful supplement to conventional ultrasound and is helpful for the differential diagnosis between the two.