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目的:利用声脉冲辐射力弹性成像技术评价和分析肝泡球蚴病病灶边缘移行带平均剪切波速度值与其纤维化程度的相关性,探讨平均剪切波速度值在病灶增殖活性的应用价值。方法:41例肝泡球蚴病患者均行肝脏声脉冲辐射力弹性成像技术检查,获得二维超声及弹性图像,对应病理取材部位测得病灶实质、边缘区域及周围肝脏组织平均剪切波速度值,并进行比较;取其中35例患者的术后或穿刺活检组织标本,对病灶边缘区域取材,行Masso N染色和HE染色,分析边缘移行带平均剪切波速度值与镜下纤维化程度的相关性。结果:41例患者的病灶实质、病灶边缘区域和周围肝脏组织的平均剪切波速度值比较差异有统计学意义(P<0.05);35例患者术后组织标本显示病灶边缘区域的平均剪切波速度值随纤维化程度增加而波速增高,有明显相关性。结论:肝泡球蚴病灶边缘存在较周围肝实质高、较病灶内部低平均剪切波速度值的移行带;移行带平均剪切波速度值在一定程度上反映了病灶新近的纤维化程度变化,可用于评价病灶浸润增殖活性;移行带的平均剪切波速度值与镜下纤维化程度明显正相关;具有早期、准确、可定量的优势;声脉冲辐射力弹性成像技术有望用于评价肝泡球蚴病灶的浸润增殖活性及术后评估,有助于肝泡球蚴病自体肝移植的术前及术后评估。
OBJECTIVE: To evaluate and analyze the correlation between the average shear wave velocity and the degree of fibrosis in the transitional zone of hepatic hydatid disease with acoustic pulse radiation elastography, and to explore the value of the average shear wave velocity in the proliferative activity of the lesion . Methods: Forty-one cases of patients with alveolar echinococcosis were examined by acoustic emission elastography. Two-dimensional ultrasonography and elastography were performed. The average shear wave velocity in the parenchyma, marginal region and surrounding liver tissue Value and compare them.Among the 35 cases of postoperative or biopsy tissue specimens, the edge of the lesion area were drawn, Masson N staining and HE staining, the edge of the transition zone with the average shear wave velocity and the degree of microscopic fibrosis Relevance. Results: There were significant differences in the mean value of shear wave velocity in the parenchyma, marginal zone and surrounding liver tissue in 41 cases (P <0.05). The average of the average shear wave velocity in the marginal zone of 35 cases Wave velocity value increased with the degree of fibrosis and wave velocity increased, there is a clear correlation. CONCLUSION: There is a transition zone between the edge of hepatic hydatid cyst and its surrounding liver parenchyma, which is lower than the average internal shear wave velocity of the lesion. The mean shear wave velocity of the transition zone reflects the recent change of the degree of fibrosis , Which could be used to evaluate the infiltration and proliferative activity of lesions. The mean shear wave velocity of transition zone was positively correlated with the extent of microscopic fibrosis. It had the advantages of early, accurate and quantitative quantification. The acoustic pulse radiation elastography is expected to be used to evaluate the liver Invasive proliferative activity and postoperative evaluation of cysticercosis lesions contribute to the preoperative and postoperative evaluation of autologous liver transplantation for alveolar echinococcosis.