CAJ | 학술논문

目的：对肝局灶性病变进行剪切波弹性成像（shear wave elastography ，SWE），探讨图像质量的影响因素和检查的可重复性。方法对符合纳入标准（病灶于右肋间切面二维声像图上清晰显示且深度＜10 cm ）的连续289例患者305个病灶进行SWE检查。根据图像质量分为“满意”、“基本满意”、“不满意”3组，比较3组之间腹壁厚度、病灶深度、大小及位置的差异。由两位医生分别独立对连续20例患者20个病灶进行SWE成像并测量杨氏模量。由同一位医生对另外连续20例患者20个病灶于不同时间进行SWE成像并测量杨氏模量。应用组内相关系数评价检查者之间及检查者内部的可重复性。结果图像质量“满意”179个，“基本满意”107个，“不满意”19个。3组之间腹壁厚度差异具有统计学意义[满意组（13．4±03．5）cm ，基本满意组（16．3±03．6）cm ，不满意组（18．7±03．9）cm ，P ＜00．01]。3组之间病灶深度、大小及部位分布差异无统计学意义。病灶及其邻近肝实质的各弹性参数，检查者之间及检查者内部的组内相关系数均＞07．5。病灶各弹性参数中，以杨氏模量最大值重复性最好，检查者之间和检查者内部组内相关系数分别为09．0和09．6。结论 SWE可用于评价在右肋间切面二维声像图上清晰显示且深度＜10 cm的肝局灶性病变，是一种成功率高且可重复性好的技术。
목적：대간국조성병변진행전절파탄성성상（shear wave elastography ，SWE），탐토도상질량적영향인소화검사적가중복성。방법대부합납입표준（병조우우륵간절면이유성상도상청석현시차심도＜10 cm ）적련속289례환자305개병조진행SWE검사。근거도상질량분위“만의”、“기본만의”、“불만의”3조，비교3조지간복벽후도、병조심도、대소급위치적차이。유량위의생분별독립대련속20례환자20개병조진행SWE성상병측량양씨모량。유동일위의생대령외련속20례환자20개병조우불동시간진행SWE성상병측량양씨모량。응용조내상관계수평개검사자지간급검사자내부적가중복성。결과도상질량“만의”179개，“기본만의”107개，“불만의”19개。3조지간복벽후도차이구유통계학의의[만의조（13．4±03．5）cm ，기본만의조（16．3±03．6）cm ，불만의조（18．7±03．9）cm ，P ＜00．01]。3조지간병조심도、대소급부위분포차이무통계학의의。병조급기린근간실질적각탄성삼수，검사자지간급검사자내부적조내상관계수균＞07．5。병조각탄성삼수중，이양씨모량최대치중복성최호，검사자지간화검사자내부조내상관계수분별위09．0화09．6。결론 SWE가용우평개재우륵간절면이유성상도상청석현시차심도＜10 cm적간국조성병변，시일충성공솔고차가중복성호적기술。
Objective To investigate the influencing factors of quality of shear wave elastography (SWE) image and the reproducibility of using SWE for focal liver lesions .Methods A total number of 289 consecutive patients with 305 lesions (the lesions could be detected on baseline ultrasound with intercostals approach ,and the depth of lesion was less than 10 cm) were undergone SWE examination .The SWE values of both lesion and adjacent liver parenchyma were measured .The quality of images was classified into three grades:“Good” ,“Common” ,and “Poor” .The depth of lesion ,the distance from body surface to liver capsule ,diameter and location of lesion were compared among three groups .Twenty consecutive patients with 20 lesions were performed SWE by two operators and another 20 consecutive patients with 20 lesions were performed SWE by one operator at different time .Intra‐class correlation coefficient was used to evaluate the reproducibility of inter‐ and intra‐ observer .Results A total number of 179 lesions were“Good” ,107“Common” and 19 “Poor” .The distance from body surface to liver capsule was significantly different among three groups [(Good (1 3.4 ± 0 3.5)cm ,Common (1 6.3 ± 0 3.6)cm ,Poor (1 8.7 ± 0 3.9)cm , P < 0 0.01] .No significant difference was found for the depth ,diameter and location of lesions among three groups .For all parameters of SWE both lesion and adjacent parenchyma ,intra‐class correlation coefficient of inter‐and intra‐observer were higher than 0 7.5 .The reproducibility of max SWE value was best of four elasticity parameters for lesion ,which intra‐class correlation coefficient of inter‐and intra‐observer was 0 9.0 and 0 9.6 ,respectively .Conclusions For focal liver lesions which could be detected on baseline ultrasound and the depth of lesions was less than 10 cm ,SWE could be used to evaluate elasticity characteristics with good feasibility and reproducibility .