The purpose of this study was to determine the possibility of ARFI- elastography for diagnosis of tumors of the liver. The study included 95 patients with liver tumors. 22 patients were excluded from the study because of the deep location of the formation or the inability to measure the speed performance. Therefore the tumors in 73 patients were obtained by ARFI-elastography and analyzed. Verification of the diagnosis was achieved by histological examination of the material in 93% of cases and by MRI, CT in 7% of cases. Patients were divided by diagnosis: 4 – with benign tumors, 33 – with hepatocellular carcinoma, 4 – with cholangio-carcinoma, 19 – with metastatic colorectal cancer, 13 – with metastases of other cancer. Benign tumors included two focal nodular hyperplasia and hepatocellular adenoma, one cavernous hemangioma a large size. The obtained results were compared with normal liver parenchyma in 77 people. Average speed was: 2.83 m/s in the benign, 1.55 m/s in the normal liver parenchyma, 2.5 m/s at the nodes of hepatocellular carcinoma, 2.66 m/s at the nodes cholangio-carcinomar, 2.79 m/s in the metastasis of colorectal cancer, 2.79 m/s in the remaining metastases. Associated threshold value for the diagnosis of the majority of malignant tumors, it is necessary to consider the speed of over 2 m/s. Sensitivity groups ranged from 59% to 100% and a specificity of 70% to 86%. The results indicate higher speed performance parameters (mean, median, threshold values > 2.3 m/s) in benign tumors. This is due to a small group, as well as the large size of entities – from 5.0 to 24.0 cm, indicating that the long-term course of the disease with the development of fibrosis in them, so the stiffness of education becomes higher. These data prove that the quantitative elastography shear wave can be used as an additional diagnostic tool in oncology, but further accumulation of scientific data, since the values of the groups overlap.
ultrasound, acoustic radiation force impulse, elastography, focal liver mass
1. Gudilina E.A. Vozmozhnosti ul´trazvukovoy tomografii i dopplerografii v diagnostike novoobrazovaniy grudnoy stenki, plevry, legkikh i sredosteniya: avtoref dis.... kand. med. nauk. M., 2003.
2. Zykin B.I., Postnova N.A., Medvedev M.E. Ul´trazvukovaya elastografiya. Meditsinskiy alfavit. 2013. T. 1-2. №10. S. 14–19.
3. Kostyakova L.A. Vozmozhnosti ul´trazvukovoy tomografii v diagnostike i otsenke effektivnosti lecheniya opukholey oporno-dvigatel´nogo apparata: avtoref dis.... kand. med. nauk. M., 2002.
4. Sinyukova G.T., Korzhenkova G.P., Danzanova T.Yu. Ul´trazvukovoe issledovanie molochnoy zhelezy v onkologii: Prakticheskoe rukovodstvo. M., 2007. 160 s.
5. Vozmozhnosti primeneniya ARFI-elastometrii dlya otsenki zhestkosti podzheludochnoy zhelezy u detey / Feoktistova E.V., Pykov M.I., Amosova A.A. [i dr.]. Ul´trazvukovaya i funktsional´naya diagnostika. 2014.№1. S. 54–62.
6. Liver elastography, comments on EFSUMB elastography guidelines 2013 / Cui X.W., Friedrich-Rust M., De Molo C. [et al.]. World J Gastroenterol. 2013. V. 38. N19. P. 6329–6347.
7. Evaluation of liver tumors using acoustic radiation force impulse elastography and correlation with histologic data / Frulio N., Laumonier H., Carteret T. [et al.]. J Ultrasound Med. 2013. V. 32. N1. P. 121–130.
8. Acoustic Radiation Force Impulse (ARFI) ultrasound imaging of solid focal liver lesions / Gallotti A., D´Onofrio M., Romanini L. [et al.]. Eur J Radiol. 2012. 81. P. 451–455.
9. Real time elastography - a non-invasive diagnostic method of small hepatocellular carcinoma in cirrhosis / Gheorghe L., Iacob S., Iacob R. [et al.]. J Gastrointestin Liver Dis. 2009. 18. P. 439–446.
10. Heide R., Strobel D., Bernatik T., Goertz R.S. Characterization of focal liver lesions (FLL) with acoustic radiation force impulse (ARFI) elastometry. Ultraschall Med. 2010. 31. P. 405–409.
11. Clinical utility of acoustic radiation force impulse imaging for identification of malignant liver lesions: a meta-analysis / Ying L., Lin X., Xie Z.L. [et al.]. Eur Radiol. 2012. 22. P. 2798–2805.
