Study on the relationship between shear wave elatography imaging parameters and lesion histopathology and repeatability analysis of liver hardness in patients with liver cancer
Objective To investigate the relationship between shear wave elatography(SWE)imaging parameters and lesion histopathology and repeatability analysis of liver stiffness measurement(LSM)in patients with liver cancer.Methods The clinicopathological data of 116 patients with liver tumors from December 2019 to January 2023 were collected,including 55 cases of hepatic hemangioma and 61 cases of liver cancer.SWE ultrasound diagnostic instrument was used to obtain and record LSM.Spearman rank correlation analysis was used to analyze the correlation between LSM and Child-Pugh classification,hepatitis activity and staging of hepatic fibrosis.The receiver operating characteristic curve(ROC)was used to evaluate the differentiation between hemangioma and liver cancer and the diagnostic efficacy of SWE for different clinicopathological features of liver cancer.Intra-group correlation coefficient(ICC)was used to analyze the consistency of measurements of different operators and the same operator.Results The LSM of hepatic hemangioma was(19.49±7.54)kPa,while that of liver cance was(39.17±14.35)kPa,the difference was statistically significant(P<0.001).There was a statistically significant difference in LSM between patients with different liver function Child-Pugh grading,liver function inflammation grading,and liver function sclerosis grading(P<0.05).The critical point of LSM in the diagnosis of liver cancer and hepatic hemangioma was 23.54 kPa,with a sensitivity of 79.85%and a specificity of 91.16%.The area under the ROC curve(AUC)was 0.900(95%CI:0.825-0.966).LSM was positively correlated with staging of hepatic fibrosis(r=0.850,P<0.001),hepatitis activity(r= 0.633,P<0.001)and Child-Pugh classification(r= 0.367,P<0.001).The AUC of hepatic fibrosis(≥F2)and cirrhosis(F4)identified by SWE technique were 0.621(95%CI:0.573-0.824)and 0.773(95%CI:0.621-0.864),respectively,while the AUC of≥A2 and A3 hepatitis identified by SWE technique were 0.605(95%CI:0.583-0.864)and 0.759(95%CI:0.573-0.872),respectively.The AUC of Child-Pugh grade C identified by SWE technique was 0.722(95%CI:0.615-0.906).The intra-and inter-group ICC of LSM in patients with hepatic hemangioma and liver cancer measured by different operators were greater than 0.75.Conclusion SWE is a simple and reproducible method for detecting liver stiffness,which can well distinguish liver cancer from hepatic hemangioma,and can also evaluate the degree of liver fiber,hepatitis activity and Child-Pugh grade in patients with liver cancer.The influence of the operators' experience on repeatability is limited.
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