Journal of Hebei Medical University ›› 2023, Vol. 44 ›› Issue (8): 956-960.doi: 10.3969/j.issn.1007-3205.2023.08.016

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Preliminary clinical study of preoperative evaluation of hepatic fibrosis in patients with hepatocellular carcinoma by shear wave dispersion

  

  1. 1.Department of Function, the Special Care Hospital of Hebei Province, Shijiazhuang 050051, China; 
    2.Department of Radiology, the Special Care Hospital of Hebei Province, Shijiazhuang 
    050051, China; 3.Department of Ultrasound, the Affiliated Hospital of Binzhou 
    Medical University, Shandong Province, Binzhou 256603, China
  • Online:2023-08-25 Published:2023-08-28

Abstract: Objective To evaluate the clinical application value of shear wave dispersion (SWD) in preoperative evaluation of liver fibrosis in patients with hepatocellular carcinoma (HCC). 
Methods A total of 152 patients with HCC from Special Care Hospital of Hebei Province and the Affiliated Hospital of Binzhou Medical University who planned to undergo hepatectomy were enrolled. SWD of liver parenchyma > 2 cm away from the tumor lesion was performed, and the median value was taken after 10 measurements. Hepatic parenchyma fibrosis was graded according to Scheuer standard, and the diagnostic value of SWD was analyzed by receiver operating characteristic (ROC) curve. 
Results Postoperative pathological examination of liver parenchyma around tumor revealed S1 stage in 13 cases, S2 stage in 31 cases, S3 stage in 47 cases and S4 stage in 61 cases.  The SWD of liver parenchyma showed good intraobserver and interobserver consistency. SWD was positively correlated with liver fibrosis grading (r=0.570, P<0.001). The median SWD of liver was 11.83 m/s·kHz-1,13.58 m/s·kHz-1,15.17 m/s·kHz-1, and 17.35 m/s·kHz-1 for S1-S4, respectively, and there was significant difference in SWD of the liver among all groups (P< 0.05). The areas under ROC curves of SWD in diagnosis at ≥S2, ≥S3,=S4 stage were 0.875, 0.812 and 0.784, respectively. With 12.6 m/s·kHz-1 as the optimal cutoff value, the sensitivity and specificity of SWD in diagnosing S≥2 were 83.70% and 77.78%, respectively. With 13.4 m/s·kHz-1 as the optimal cutoff value, the sensitivity and specificity of S≥3 were 74.13% and 72.88%, respectively. With 14.6 m/s·kHz-1 as the optimal cutoff value, the sensitivity and specificity of S=4 were 83.95% and 62.00% respectively. 
Conclusion WD can noninvasively measure SWD value of liver parenchyma in HCC patients, which can reflect the degree of liver parenchyma fibrosis, providing a new method for preoperative quantitative evaluation of liver fibrosis stage. 


Key words: liver neoplasms, hepatic fibrosis, ultrasonography