关键词: 超声剪切波频散成像, 肝细胞肝癌, 肝纤维化, 评估价值

Abstract:

Objective To evaluate the diagnostic value of shear wave dispersion （SWD） in preoperative assessment of liver fibrosis in patients with hepatocellular carcinoma （HCC）. Methods A total of 62 patients with HCC who were admitted to the hospital between January 2022 and January 2024 were included in this study. All patients underwent shear wave elastography （SWE） examination prior to hepatectomy. The extent of liver fibrosis was assessed based on surgical and pathological findings. Patients were categorized into two groups： a low?grade fibrosis group （stages S0?S2） and a high?grade fibrosis group （stages S3?S4）. Baseline characteristics and liver parenchymal SWE values were compared between the two groups. Multivariate logistic regression analysis was conducted to identify factors influencing the degree of liver fibrosis in HCC patients. The diagnostic performance of SWE in preoperative evaluation of liver fibrosis was assessed using receiver operating characteristic （ROC） curve analysis. Results Among the 62 patients with HCC， pathological results indicated that there were 11， 13， 20， and 18 cases in fibrosis stages S1， S2， S3， and S4， respectively. The SWD values of liver parenchyma significantly differed among patients with varying degrees of liver fibrosis. As the severity of liver fibrosis increased， the SWD of liver parenchyma also increased （P < 0.05）. Spearman correlation analysis revealed a positive correlation between the SWD value of liver parenchyma and the degree of liver fibrosis in preoperative HCC patients （r = 0.608， P < 0.05）. Platelet count （PLT） was lower in the high?grade fibrosis group compared to the low?grade fibrosis group （P < 0.05）. Additionally， both the S index and SWD value of liver parenchyma were higher in the high?grade fibrosis group than in the low?grade fibrosis group （P < 0.05）. Multivariate logistic regression analysis demonstrated that the S index and SWD value were independent influencing factors for the degree of liver fibrosis in preoperative HCC patients （P < 0.05）. ROC curves showed that the area under the curve （AUC） of the SWD value was greater than that of the S index for assessing the degree of liver fibrosis in preoperative HCC patients （P < 0.05）. The cutoff value， sensitivity， and specificity of the SWD value for assessing the degree of liver fibrosis were 16.25 m/s·kHz?1， 65.79%， and 95.83%， respectively. Conclusion The SWD value of liver parenchyma is closely associated with the extent of liver fibrosis in patients with HCC and provides a highly valuable assessment of the degree of liver fibrosis.

Key words: shear wave dispersion, hepatocellular carcinoma, liver fibrosis, evaluate value