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Expert Rev Gastroenterol Hepatol ; 12(2): 201-207, 2018 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29219625

RESUMO

BACKGROUND: The present study aimed at evaluation of the usefulness of point shear wave elastography (pSWE) in characterization of FLL(s) by quantifying their stiffness. METHODS: In total, 197 patients (mean age was 56.57 years) with FLL(s) on conventional ultrasound were included. Final diagnoses, confirmed by imaging and/or biopsy whenever possible, included hepatocellular carcinoma (HCC) (n = 143), metastasis (n = 36), hemangioma (n = 16), and focal nodular hyperplasia (n = 2). Stiffness evaluation was performed by pSWE. Stiffness ratio (lesion to background liver) was calculated. ROC analysis was performed to evaluate the diagnostic accuracy of the stiffness value and stiffness ratio and to extract the optimal cutoff values for characterisation of FLL(s). RESULTS: HCC was significantly softer than its surrounding liver parenchyma [5.43 (3.03) vs. 17.05 (8.53) kPa, p <0.001]. However, the stiffness values for the other examined FLLs were comparable to their surrounding liver parenchyma. No significant difference was detected across different types of metastases or between metastases and surrounding liver (p>0.05). Stiffness ratio was superior to stiffness value in discrimination of HCC from metastasis (AUROC, 0.91 vs. 0.51 respectively). CONCLUSION: pSWE could provide a complementary information about FLLs especially in differentiation between HCCs from metastases.


Assuntos
Carcinoma Hepatocelular/diagnóstico por imagem , Técnicas de Imagem por Elasticidade/métodos , Hiperplasia Nodular Focal do Fígado/diagnóstico por imagem , Hemangioma/diagnóstico por imagem , Neoplasias Hepáticas/diagnóstico por imagem , Fígado/diagnóstico por imagem , Adulto , Idoso , Idoso de 80 Anos ou mais , Área Sob a Curva , Carcinoma Hepatocelular/patologia , Diagnóstico Diferencial , Feminino , Hiperplasia Nodular Focal do Fígado/patologia , Hemangioma/patologia , Humanos , Fígado/patologia , Neoplasias Hepáticas/secundário , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Prognóstico , Curva ROC , Reprodutibilidade dos Testes
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