标题：超声声速匹配技术联合SWE对原发性肝癌及肝血管瘤的鉴别诊断价值

      作者：孔文霞 1，朱照 2，黄小平 1    孔文霞 1，朱照 2，黄小平 1西安市第九医院消化内科 1、超声医学科 2，陕西 西安 710054

      卷次： 2023年34卷14期

      【摘要】 目的 探讨超声声速匹配(SSC)技术联合剪切波弹性成像(SWE)对原发性肝癌及肝血管瘤的鉴别诊断价值，为患者的临床诊疗提供参考依据。方法 选取2021年1月至2022年6月西安市第九医院收治的55例原发性肝癌患者(肝脏肿块112个)为研究组，并选取同期55例肝血管瘤患者(肝脏肿块107个)为对照组。采用超声SSC技术检测两组患者肝脏肿块的区域速度指数(ZSI)，采用超声 SWE检测两组患者肝脏肿块的弹性模量平均值(Emean)、剪切波速度平均值(Vmean)及剪切波速度最大值(Vmax)，并采用受试者工作特征曲线(ROC)分析超声SSC技术、SWE单独及联合检测对原发性肝癌及肝血管瘤的鉴别诊断价值。结果 研究组患者肝脏肿块的ZSI值、Emean、Vmean及Vmax分别为(42.26±4.73) m/s、(36.51±3.84) kPa、(3.57±0.39) m/s、(3.88±0.41) m/s，明显高于对照组的(22.31±2.52) m/s、(17.55±1.93) kPa、(2.27±0.24) m/s、(2.59±0.28) m/s，差异均有统计学意义(P<0.05)；超声SSC技术联合SWE诊断原发性肝癌及肝血管瘤的曲线下面积(AUC)为0.991，明显高于SSC技术诊断的0.895，SWE技术Emean诊断的0.883，SWE技术Vmean诊断的0.859，SWE技术Vmax诊断的0.897，差异均有统计学意义(P<0.05)。结论 超声SSC技术联合SWE对原发性肝癌及肝血管瘤的鉴别诊断价值较高，两者联合诊断能有效提高鉴别原发性肝癌及肝血管瘤的敏感度及特异度，对患者病情快速准确诊断，对及时采取针对性治疗措施有临床指导意义。
      【关键词】 原发性肝癌；肝血管瘤；超声；声速匹配技术；剪切波弹性成像；诊断价值
      【中图分类号】 R735.7 【文献标识码】 A 【文章编号】 1003—6350（2023）14—2053—04

Value of ultrasonic sound speed correction technique combined with shear wave elastography in differentialdiagnosis of primary hepatocellular carcinoma and hepatic hemangioma.
KONG Wen-xia 1, ZHU Zhao 2, HUANGXiao-ping 1. Department of Gastroenterology 1, Department of Ultrasound Medicine 2, Xi'an Ninth Hospital, Xi'an 710054,Shaanxi, CHINA
【Abstract】 Objective To investigate the value of sound speed correction (SSC) technology combined withshear wave elastography (SWE) in the differential diagnosis of primary liver cancer and hepatic hemangioma, and to pro-vide reference for clinical diagnosis and treatment of patients. Methods A total of 55 patients with primary liver cancer(112 liver masses) admitted to Xi'an Ninth Hospital from January 2021 to June 2022 were selected as the study group,and 55 patients with hepatic hemangioma (107 liver masses) during the same period were selected as the control group.Ultrasonic SSC technology was used to detect the regional velocity index (ZSI) of liver masses in the two groups, and ul-trasonic SWE was used to detect the mean elastic modulus (Emean), mean shear wave velocity (Vmean), and maximum shearwave velocity (Vmax) of liver masses in the two groups. The receiver operating characteristic curve (ROC) was used to an-alyze the value of ultrasound SSC, SWE alone and combined detection in the differential diagnosis of primary liver can-cer and hepatic hemangioma. Results The ZSI value, Emean, Vmean, and Vmax of the liver mass in the study group were(42.26±4.73) m/s, (36.51±3.84) kPa, (3.57±0.39) m/s, (3.88±0.41) m/s, respectively, which were significantly higherthan (22.31±2.52) m/s, (17.55±1.93) kPa, (2.27±0.24) m/s, (2.59±0.28) m/s of the control group (P<0.05). The area underthe curve (AUC) of ultrasound SSC combined with SWE in the diagnosis of primary liver cancer and hepatic hemangiomawas 0.991, which was significantly higher than 0.895 of SSC, 0.883 of Emean diagnosis of SWE, 0.859 of Vmean diagnosis ofSWE, and 0.897 of Vmax diagnosis of SWE (P<0.05). Conclusion Ultrasonic SSC combined with SWE has a high valuein the differential diagnosis of primary liver cancer and hepatic hemangioma, which can effectively improve the sensitivityand specificity in the differential diagnosis of primary liver cancer and hepatic hemangioma, and has clinical guiding sig-nificance in the rapid and accurate diagnosis of patients' disease and timely application of targeted treatment measures.
      【Key words】 Primary liver cancer; Hepatic hemangioma; Ultrasound; Speed correction technology; Shear waveelastography; Diagnostic value