Usefulness of evaluating hepatic elasticity using artificial acoustic radiation force ultrasonography before hepatectomy
Usefulness of evaluating hepatic elasticity using artificial acoustic radiation force ultrasonography before hepatectomy
复制标题
DOI：
10.1111/hepr.12306
复制
发表时间：
2014-12-01
影响因子：
4.2
通讯作者：
Nagayasu, Takeshi
中科院分区：
文献类型：
--
作者：
Nanashima, Atsushi;Sakamoto, Ayami;Nagayasu, Takeshi
目的探讨超声新参数声辐射力脉冲（acoustic radiation force impulse，ARFI）对肝纤维化及肿瘤的诊断价值。结果右肝非肿瘤区Vs测量成功率为99%，左肝非肿瘤区Vs测量成功率为94%。右肝的Vs显著低于左肝，肝肿瘤的Vs显著高于非肿瘤肝。左、右侧肝Vs与血小板计数、天门冬氨酸氨基转移酶、肝纤维化指数和吲哚菁绿绿色试验相关。右肝中的Vs与纤维化标志物或指数显著相关。肝硬化和组织学4期左右肝的Vs显著高于其他肝。右肝的Vs显示接受者-操作者曲线下面积值较高，可预测组织学纤维化。在右侧的Vs与失血量和术后并发症，特别是不受控制的腹水显着相关。结论非侵入性ARFI成像弹性成像是有用的，在评估受损的肝功能或肝脏恶性肿瘤，高度肝纤维化的鉴别诊断和预测postthepatectomy发病率。
AimTo evaluate hepatic fibrosis and tumor diagnosis preoperatively, we investigated the elasticity calculated by the new parameter of ultrasonography, acoustic radiation force impulse (ARFI).MethodsWe examined ARFI of the non-tumorous right and left lateral liver and in the tumor by push pulse of probe in 95 patients with hepatic malignancies undergoing hepatectomy. Measurement of ARFI as hepatic stiffness was indicated as the Vs (m/s).ResultsMeasuring the Vs in the non-tumor region was achieved in the right liver in 99% and at the left lateral liver in 94%. The Vs in the right liver was significantly lower than in the left lateral liver, and the Vs of the liver tumor was significantly higher than in the non-tumorous liver. The Vs in the right and left lateral liver was correlated with the platelet count, aspartate aminotransferase, fibrotic indices and indocyanine green test. The Vs in the right liver was significantly correlated with the fibrotic marker or index. The Vs of liver cirrhosis and histological stage 4 in the right and left liver was significantly the highest compared to the others. The Vs in the right liver showed a high area under the receiver-operator curve value predicting histological fibrosis. The Vs in the right was significantly correlated with blood loss and postoperative complications, particularly uncontrolled ascites.ConclusionNon-invasive ARFI imaging elastography is useful in evaluating impaired liver function or in the differential diagnosis of liver malignancies, highly hepatic fibrosis and in predicting posthepatectomy morbidity.