Primary clinical application of shear wave elastography combined with shear wave dispersion in differentiating diagnosis of focal liver lesions

Abstract

Objective To investigate the initial clinical value of shear wave elastography (SWE) combined with shear wave dispersion (SWD) in preoperatively differentiating diagnosis of focal liver lesions (FLLs). Methods Eighty-three patients diagnosed as FLLs were prospectively enrolled from January to April 2018 in Zhongshan Hospital of Fudan University. Measurements of SWD and SWE both inner FLLs and surrounding liver parenchyma 2 cm away from the board lines of lesions were performed. ROIs were placed within the lesions and surrounding parenchyma 2 cm away from the lesions. In each ROI, measurements were performed 13 times. Histopathological results after operation were regarded as gold standard, and the values of viscoelasticity in differentiating diagnosis of FLLs were analyzed. Results The final histopathological results showed that of all 83 cases, 20 cases were diagnosed as benign lesions (5 cases of focal nodular hyperplasia, 15 cases of hemangioma), and 63 cases as malignant lesions (12 cases of liver metastases, 51 cases of hepatocellular carcinoma). The SWE of benign lesions and malignant lesions were (9.94±8.22)kPa, and (13.68±7.80)kPa(P<0.05). The SWD of benign lesions and malignant lesions were (13.47±2.76)(m/s)/kHz, and (15.00±3.82)(m/s)/kHz(P<0.05). The SWE ratio and SWD ratio of benign lesions to surrounding liver parenchyma were higher than those of malignant lesions(all P<0.05). The SWE ratio of benign and malignant lesions were 2.60±2.65, and 1.40±1.40, respectively (P<0.05). The SWD ratio of benign and malignant lesions were 0.92±0.44, and 0.80±0.51, respectively(P<0.05). Conclusions With the advantages of effectiveness, convenience, non-invasiveness and repeatability, combined measurement of SWE and SWD has a potential value in differentiating diagnosis of liver lesions. Key words: Shear wave elastography; Shear wave dispersion; Viscoelasticy; Liver neoplasms; Differential diagnosis