Evaluation of shearwave elastography for the characterisation of focal liver lesions on ultrasound

Eur Radiol. 2013 Apr;23(4):1138-49. doi: 10.1007/s00330-012-2692-y. Epub 2012 Nov 19.

Abstract

Objectives: To determine the elasticity characteristics of focal liver lesions (FLLs) by shearwave elastography (SWE).

Methods: We used SWE in 108 patients with 161 FLLs and in the adjacent liver for quantitative and qualitative FLLs stiffness assessment. The Mann-Whitney test was used to assess the difference between the groups of lesions where a P value less than 0.05 was considered significant.

Results: SWE acquisitions failed in 22 nodules (14 %) in 13 patients. For the 139 lesions successfully evaluated, SWE values were (in kPa), for the 3 focal fatty sparings (FFS) 6.6 ± 0.3, for the 10 adenomas 9.4 ± 4.3, for the 22 haemangiomas 13.8 ± -5.5, for the 16 focal nodular hyperplasias (FNHs) 33 ± -14.7, for the 2 scars 53.7 ± 4.7, for the 26 HCCs 14.86 ± 10, for the 53 metastasis 28.8 ± 16, and for the 7 cholangiocarcinomas 56.9 ± 25.6. FNHs had significant differences in stiffness compared with adenomas (P = 0.0002). Fifty percent of the FNHs had a radial pattern of elevated elasticity. A significant difference was also found between HCCs and cholangiocarcinomas elasticity (P = 0.0004).

Conclusions: SWE could be useful in differentiating FNHs and adenomas, or HCCs and cholangiocarcinomas by ultrasound.

MeSH terms

  • Adenoma / diagnostic imaging*
  • Adult
  • Aged
  • Aged, 80 and over
  • Cholangiocarcinoma / diagnostic imaging*
  • Diagnosis, Differential
  • Elasticity Imaging Techniques / methods*
  • Female
  • Humans
  • Liver Neoplasms / diagnostic imaging*
  • Male
  • Middle Aged
  • Reproducibility of Results
  • Sensitivity and Specificity