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目的探讨超声弹性成像技术在肝良恶性肿瘤鉴别诊断及穿刺活检中的应用价值。方法将126例患者随机分为弹性组和常规组。弹性组行肝弹性成像检查,测定肿块的弹性评分及应变率比值,根据弹性成像图特点行经皮肝肿瘤穿刺活检。常规组行常规超声检查,并行经皮肝肿瘤穿刺。结果常规超声、弹性评分法和应变率比值法诊断肝恶性肿瘤的灵敏度、特异度、准确度分别为86.1%、67.7%、78%和87.5%、96.7%、91.4%及85%、96.7%、90%,弹性超声在鉴别肝恶性肿瘤方面明显优于常规超声(P<0.05)。弹性成像引导穿刺取材的成功率和满意度也明显优于常规超声(P<0.05)。结论超声弹性成像技术对鉴别肝恶性肿瘤具有较高的诊断价值,实时引导肝肿瘤穿刺取材可有效提高穿刺成功率和取材满意度,值得临床推广应用。
Objective To investigate the value of elastography in the differential diagnosis and biopsy of benign and malignant liver tumors. Methods 126 patients were randomly divided into elastic group and conventional group. Elastic group of liver elastography examination, determination of the elastic mass and strain rate ratio, according to the characteristics of elastography percutaneous liver tumor biopsy. Conventional group routine ultrasonic examination, parallel percutaneous liver tumor puncture. Results The sensitivity, specificity and accuracy of routine ultrasound, elastic score and strain rate were 86.1%, 67.7%, 78% and 87.5%, 96.7%, 91.4% and 85%, 96.7% 90%. EUS is obviously superior to conventional ultrasound in distinguishing liver malignant tumors (P <0.05). The success rate and satisfaction of elastography guided puncture were significantly better than those of conventional ultrasound (P <0.05). Conclusion Ultrasound elastography has a high diagnostic value in differentiating malignant liver tumors. To guide the liver tumor puncture in real time can effectively improve the success rate of puncture and the satisfaction of the obtained material, which is worthy of clinical application.