Abstract:
BACKGROUND: The aim of our study is to analyze viscosity characteristics of focal liver lesions (FLLs) and the diagnostic performance of shear wave dispersion (SWD) in differentiating benign and malignant FLLs. METHODS: Between January 2018 and April 2018, 58 consecutive patients (median age 57, age range 21-74 years, 37 males) with 58 FLLs located on the right lobe of liver were prospectively studied. The Aplio i900 series diagnostic ultrasound system (Canon Medical systems) equipped with a curvilinear PV1-475BX transducer (1-8 MHz) was used. SWD slope and viscosity measurements were expressed as mean ± standard deviation for both liver tumors and background liver parenchyma. Histopathological results after surgery were regarded as the gold standard for diagnosis. RESULTS: Final diagnosis included 40 cases of malignant and 18 cases of benign FLLs. The mean viscosity value were 14.78 ± 1.86 m/s/kHz for hepatocellular carcinoma (n = 30), 14.81 ± 2.35 m/s/kHz for liver metastasis lesions (n = 10), 13.23 ± 1.31 m/s/kHz for hemangioma (n = 13), and 13.67 ± 2.72 m/s/kHz for focal nodular hyperplasia (n = 5). Malignant FLLs showed higher mean viscosity values (14.79 ± 3.15 m/s/KHz) than benign FLLs (13.36 ± 2.76 m/s/KHz) (p < 0.05). The best performing cut-off value of lesion viscosity was 13.15 m/s/kHz (sensitivity 83.3 %; specificity 56.5 %; area under the curve (AUC) 0.71) for malignancy) (p < 0.05). CONCLUSIONS: The analysis of SWD slope and liver viscosity parameters provide additional viscoelastic information about FLLs before operation. EINLEITUNG: Ziel der Studie ist es die Viskosität fokaler Leberläsionen (FLL) zu bestimmen und die Aussagekraft der Scherwellendispersion zur Differenzierung von benignen und malignen Leberraumforderung zu validieren. METHODE: Zwischen Januar und April 2018 wurden 58 konsekutive Patienten (medianes Alter der Patienten 57 (21–74) Jahre, 37 Männer) mit FLL im rechten Leberlappen prospektiv untersucht. Die Untersuchungen erfolgten mit einem hochauflösenden Ultraschallgerät Canon Aplio i900, ausgerüstet mit einem kurvilinearen Schallkopf PV1-475BX (1–8 MHz). Die Scherwellendispersion und Viskositätmessungen wurden ausgedrückt als Mittelwert ± Standardabweichung, sowohl für die FLL, als auch für das Leberparenchym. Der Goldstandard war die histopathologische Untersuchung der FLL nach chirurgischer Resektion. ERGEBNISSE: Die finale Diagnose beinhaltete 40 Patienten mit malignen und 18 Patienten mit benignen FLL. Die mittleren Viskositätswerte lagen bei 14,78 ± 1,86 m/s/kHz für hepatozelluläre Karzinome (n = 30), 14,81 ± 2,35 m/s/kHz für Lebermetastasen (n = 10), 13,23 ± 1,31 m/s/kHz für Hämangiome (n = 13) und 13,67 ± 2,72 m/s/kHZ für fokale noduläre Hyperplasien (n = 5). Maligne fokale Leberläsionen zeigten (14.79 ± 3.15 m/s/KHz) höhere Viskositätswerte als gutartige fokale Leberläsionen (13.36 ± 2.76 m/s/KHz) (P < 0,05). Bei einem angenommenen Wert von 13,15 m/s/kHz betrug die Sensitivität für die richtige Erkennung maligner Raumforderungen 83,3 %, die Spezifität 56,5 %, die Fläche unter der Kurve (area under the curve (AUC) 0,71, p < 0,05). SCHLUSSFOLGERUNG: Die Analyse der Leberviskositätsmessung mittels Scherwellendispersion gibt zusätzliche Informationen zur Charakterisierung fokaler Leberläsionen.
journal_name
Z Gastroenteroljournal_title
Zeitschrift fur Gastroenterologieauthors
Dong Y,Qiu Y,Zhang Q,Yang D,Yu L,Wang WP,Dietrich CFdoi
10.1055/a-1217-7465subject
Has Abstractpub_date
2020-09-01 00:00:00pages
847-854issue
9eissn
0044-2771issn
1439-7803journal_volume
58pub_type
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