SHEAR WAVE ELASTOGRAPHY SHEAR WAVE ELASTOGRAPHY with SUPERSONIC SHEAR IMAGINGwith SUPERSONIC SHEAR IMAGING

of 69 LIVER TUMORS of 69 LIVER TUMORS

PHUC VINH DINH LE, THU DUY NGUYEN, HUNG THIEN NGUYEN, HAI THANH PHANPHUC VINH DINH LE, THU DUY NGUYEN, HUNG THIEN NGUYEN, HAI THANH PHAN

MEDIC MEDICAL CENTER, HCMC, VIETNAMMEDIC MEDICAL CENTER, HCMC, VIETNAM

PURPOSESPURPOSES

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 METHODSMATERIAL and METHODS

A descriptive, cross-sectional, prospective study A descriptive, cross-sectional, prospective study was carried out on 69 liver tumors from April to was carried out on 69 liver tumors from April to December 2010. December 2010.

2 groups of liver tumors which were noted with 2 groups of liver tumors which were noted with conventional ultrasound some morphological conventional ultrasound some morphological criteria (numbers, dimensions, margins, criteria (numbers, dimensions, margins, echogeneicity, homogeneity, halo sign, vascular echogeneicity, homogeneity, halo sign, vascular invasion) and tumoral hemodynamics invasion) and tumoral hemodynamics (vascularization, spectral pattern, velocity) and (vascularization, spectral pattern, velocity) and then, the stiffness by SWE. then, the stiffness by SWE.

U test was used for statistical analysis. U test was used for statistical analysis.

RESULTSRESULTS Group 1 (n=36 cases), average of age= 42, average of Group 1 (n=36 cases), average of age= 42, average of

dimension= 28mm,  single tumor (92%), hyperechoic, dimension= 28mm,  single tumor (92%), hyperechoic, homogeneous (85%), well-limited (90%), negative halo homogeneous (85%), well-limited (90%), negative halo sign (100%), no Doppler signal (95%), with the average sign (100%), no Doppler signal (95%), with the average of stiffness (elastic score)= 07.88kPa.of stiffness (elastic score)= 07.88kPa.

Group 2 (n=33), average of age =56, average of Group 2 (n=33), average of age =56, average of dimension=46mm, single tumor (82%), multiple tumor dimension=46mm, single tumor (82%), multiple tumor (18%), hypoechoic (60%), mixed echogeneicity (30%), (18%), hypoechoic (60%), mixed echogeneicity (30%), hyperechoic (10%), positive halo sign (65%), vascular hyperechoic (10%), positive halo sign (65%), vascular bending (30%), hypervascular (80%),  with the average bending (30%), hypervascular (80%),  with the average of stiffness (elastic score) = 84.34kPa. of stiffness (elastic score) = 84.34kPa.

2 groups of  liver tumors are distinctively different in the 2 groups of  liver tumors are distinctively different in the u-test  (α = 0.01). u-test  (α = 0.01).

Hemangioma, elastic score (ES) =17.31kPa.

Hemangioma, elastic score (ES) =17.31kPa.

Malignant tumor, elastic score =41.76kPa.

Malignant tumor, V= 3.73m/sec, elastic score = 41.76kPa.

Malignant tumor, elastic score = 41.76kPa, V= 3.73m/sec.

Multiple HCC on SWE Ultrasound and CT, elastic score = 118.02 KPaMultiple HCC on SWE Ultrasound and CT, elastic score = 118.02 KPa

Multiple HCC on SWE Ultrasound and CT, elastic score = 118.02 KPaMultiple HCC on SWE Ultrasound and CT, elastic score = 118.02 KPa

CONCLUSIONSCONCLUSIONS

SWE  of Supersonic Imagine provides SWE  of Supersonic Imagine provides quantitatively the stiffness, a new sonographic quantitatively the stiffness, a new sonographic criteria for charactization of the malignancy of criteria for charactization of the malignancy of liver tumor and others. liver tumor and others.

It makes a reliable difference in diagnosing the It makes a reliable difference in diagnosing the benign liver tumors and the malignant ones and benign liver tumors and the malignant ones and may becomes a potential method.may becomes a potential method.

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