PHUC VINH DINH LE, THU DUY NGUYEN, HUNG THIEN NGUYEN, HAI THANH PHAN, MEDIC MEDICAL CENTER, HCMC, VIETNAM
PURPOSES: To compare the stiffness of malignant liver tumors to benign liver tumors by a new technique of ultrasound, quantitative shear wave elastography (SWE). MATERIAL and METHOD: A descriptive, cross-sectional, prospective study was carried out on 69 liver tumors at MEDIC MEDICAL CENTER, HCMC, VIETNAM from April to December 2010. We had 2 groups of liver tumors which were noted with conventional ultrasound some morphological criteria (numbers, dimensions, margins, echogeneicity, homogeneity, halo sign, vascular invasion) and tumoral hemodynamics (vascularization, spectral pattern, velocity), and then, the stiffness by SWE . U test was used for statistical analysis. RESULTS: Group 1 (n=36 cases), average of age= 42, average of dimension= 28mm, single tumor (92%), hyperechoic, homogeneous (85%), well-limited (90%), negative halo sign (100%), no Doppler signal (95%), with the average of stiffness (elastic score)=07.88kPa. Group 2 (n=33), average of age =56, average of dimension=46mm, single tumor (82%), multiple tumor (18%), hypoechoic (60%), mixed echogeneicity (30%), hyperechoic (10%), positive halo sign (65%), vascular bending (30%), hypervascular (80%), with the average of stiffness (elastic score) = 84.34kPa . 2 groups of liver tumors are distinctively different in the u-test (α = 0.01). CONCLUSIONS: SWE of Supersonic Imagine provides quantitatively the stiffness, a new sonographic criteria for charactization of the malignancy of liver tumor and others . It makes a reliable difference in diagnosing the benign liver tumors and the malignant ones and may becomes a potential method to characterize liver tumors.
Fig. 1 A, B= Hemangioma, Elastic score=17.31kPa.
Fig. 2 A, B: Malignant tumor, Elastic score=41.76kPa.
Fig. 3 A: Multifocal HCC, ES=118.02kPa, B: CT scan: Multifocal HCC