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Background and Purpose of hepatocellular carcinoma is the most common malignancy in the world within one incidence of ranks fifth in the world, the third highest in the mortality rate. Ultrasound is one of the most commonly used means of diagnosis of liver disease, because of its convenient, non-invasive, inexpensive and so are a wide range of applications in the diagnosis and differential diagnosis of various liver diseases. Routine ultrasound by observing the size of the lesion, edge, shape, internal echo, made of liver disease, benign and malignant diagnosis, there are some limitations. Ultrasound elasticity imaging technology is a new technology developed in recent years, was first proposed in 1991 by Ophir, etc. By understanding detect the hardness of the organization to discriminate benign from malignant superficial examination of the organs have been more mature applications, especially in the differential diagnosis of benign and malignant lesions of the value of a positive. Studies have reported that the sensitivity, specificity, and accuracy of diagnosis of breast cancer ultrasound elastography up to 78.0%, 98.5% and 93.8%, respectively. Ultrasound elastography can not completely replace conventional ultrasound, but it significantly improves the accuracy of the ultrasonic diagnosis of breast tumors. The research and application of ultrasound elastography in liver tumors less different from the the superficial organs elastic imaging, with a certain degree of particularity. The study of liver lesions in real-time ultrasound elasticity imaging study, and were compared with pathological, to investigate the value of ultrasound elastography in the differential diagnosis of liver benign and malignant tumors. Method 1, the valuation of the ultrasound elastography to identify benign and malignant tumors of the liver: conventional ultrasound and ultrasound elastography were carried out on 224 of the 207 patients with liver tumors examination, all patients were confirmed by pathology. Routine ultrasound and elastography examination results and pathological findings. 2, the ratio of the ultrasonic elastic strain rate value in the diagnosis of liver tumors: a total of 157 of 145 patients with liver tumors ultrasound elastography examination, elastography map, measuring the lesion and surrounding tissue elastic strain rate ratio ( strain ratio, SR), after pathological control using receiver operating characteristic (receiver operator characteristic, ROC) curve analysis accuracy SR diagnosis of benign and malignant tumors, and to determine the critical point. Ultrasound elastography valuation identify benign and malignant tumors of the liver: pathological results: 77 benign lesions, including 62 hepatic hemangioma, focal nodular hyperplasia 6, three hepatic vascular endothelial cell tumor, liver vascular 2 leiomyolipoma four liver abscess; 147 malignant lesions, including hepatocellular carcinoma of the liver cells 113, 11 cholangiocarcinoma, 8 mixed type of liver cancer, metastatic liver cancer 15. Conventional two-dimensional ultrasound diagnosis of liver tumors, the sensitivity was 74.8%, specificity 74.0%, accuracy 74.6%. Ultrasound elasticity imaging sensitivity for the diagnosis of liver tumors was 83.7%, specificity of 87.0%, and accuracy of 84.8%, a positive predictive value of 92.5%, negative predictive value of 73.6%. 2, the value of ultrasonic elastic strain rate ratio in the diagnosis of liver tumors: benign tumor of SR 2.75 ± 1.26, the malignancy of SR is 8.33 ± 4.45, the difference has a significant statistical significance (P lt; 0.01 ). Cholangiocarcinoma group SR highest metastatic liver cancer and liver cells liver cancer group, followed by the liver hemangioma lowest. ROC curve to determine the best diagnostic critical point is 4.0, sensitivity, specificity, accuracy, positive predictive value, and negative predictive value were 89.4%, 86.8%, 88.5%, 93.0% and 80.7%. The area under the curve (AUC) = 0.941. Conclusion 1, ultrasound elastography in the differential diagnosis of liver tumors of benign and malignant accuracy than conventional ultrasound. Ultrasound elastography technology provides a new method for the diagnosis of liver tumors and help to identify benign and malignant liver tumors. 2, the ratio of the elastic strain rate measurements can be more objectively reflect the lesion hardness is a more accurate and objective diagnosis of benign and malignant liver of the new method of ultrasound elastography.
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