Value of two-dimensional shear wave elastography in the typing of liver Cystic echinococcosis

doi:10.3877/cma.j.issn.1674-1358.2025.01.008

Abstract

Abstract:

Objective

To investigate the value of two-dimensional shear wave elastography (2D-SWE)in the typing of liver Cystic echinococcosis (CE).

Methods

Total of 91 patients with liver CE were admitted to the Fourth People’s Hospital of Qinghai Province from July 2018 to July 2023.Ultrasound, 2D-SWE, CT or MRI examinations were performed on each patient.As 2D-SWE had almost zero shear wave propagation speed in cystic lesions, 41 cases of CE1 and CE2 type were excluded.Total of 50 cases of CE3-CE5 type with solid components were enrolled as study subjects.According to the CT/MRI results, the patients were divided into CE3 group(15 cases), CE4 group (19 cases) and CE5 group (16 cases).The statistical data (age, left and right diameter of lesion,anterior and posterior diameter of lesion, CE hardness value, surrounding liver hardness value) of overall comparison among the three groups were analyzed by One-way analysis of variance, while pairwise comparison in each group were analyzed by LSD-t test.Counting data (sex, number of lesions and location of lesions) were obtained using Pearson Chi-square test or Fisher’s exact probability method, the correlation analysis was conducted using Spearman rank correlation analysis.The diagnostic capability of the correlation between CE classiflcation and CE hardness value was evaluated by receiver operating characteristic curve (ROC) and area under ROC curve (AUC).

Results

The average hardness values of CE3, CE4 and CE5 were (15.77 ± 5.83) kPa, (34.15 ± 9.28) kPa and (50.80 ± 13.73)kPa, respectively.The correlation analysis results showed that CE classiflcation was positively correlated with the average hardness value of CE (r = 0.821, P ＜ 0.001).The CE hardness values among patients in CE3 group, CE4 group and CE5 group were signiflcantly different (F = 45.991, P ＜ 0.001), while the pairwise comparison results between the CE hardness values showed that the differences were statistically signiflcant (CE3 group vs.CE4 group:t =-5.236, P ＜ 0.001, CE3 group vs.CE5 group: t =-9.590, P ＜ 0.001, CE4 group vs.CE5 group: t =-4.828,P ＜ 0.001).The AUC of 2D-SWE for diagnosis type of CE3 and CE4 was 0.941 (95%CI: 0.867-1.000, P ＜ 0.001),with the cut-off value of 19.5 kPa, the sensitivity and speciflcity of 2D-SWE were 94.7% and 73.3%, respectively.The AUC of 2D-SWE for diagnosis type of CE4 and CE5 was 0.826 (95%CI: 0.684-0.967, P ＜ 0.001), with the cutoff value of 47.5 kPa, the sensitivity and speciflcity of 2D-SWE were 62.5% and 89.5%, respectively.

Conclusions

2D-SWE is a safe, economical, non-invasive, rapid, and visualization imaging method, which quantitatively assesses the biomechanical characteristics of liver CE.It serves as an excellent detection tool for typing CE3, CE4 and CE5.Furthermore, the 2D-SWE color elastic map provides real-time display of the distribution of softness and hardness within the CE lesion area.This information can serve as a valuable reference for selecting appropriate mode of operation and surgical instrument.

Key words: Two-dimensional shear-wave elastography, Liver cystic echinococcosiss, Quantitative, Classiflcation

Zhenming Yuan, Jianying Guo, Yuhua Pang, Jinhuan Wang, Dancairang Yang, Guoying Yu. Value of two-dimensional shear wave elastography in the typing of liver Cystic echinococcosis[J]. Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition), 2025, 19(01): 44-51.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://zhsyhlcgrbzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-1358.2025.01.008

https://zhsyhlcgrbzz.cma-cmc.com.cn/EN/Y2025/V19/I01/44

Figures/Tables 7

指标	CE3型组（15例）	CE4型组（19例）	CE5型组（16例）	统计量	P值
年龄（ $\overset{ˉ}{x}$ ± s，岁）	41.73 ± 12.59	44.29 ± 16.66	52.93 ± 14.57	F = 2.378	0.105
性别［例（%）］				χ ²= 0.398	0.819^a
男	8（53.33）	12（63.16）	10（62.50）
女	7（56.66）	7（36.84）	6（37.5）
病灶数目［例（%）］				—	0.562^b
单个	12（80.00）	17（89.47）	15（93.75）
≥ 2	3（20.00）	2（10.53）	1（6.25）
病灶部位［例（%）］				—	0.976^b
左叶	3（20.00）	5（26.32）	5（31.25）
右叶	10（66.67）	12（63.15）	10（62.50）
左右叶	2（13.33）	2（10.53）	1（6.25）
病灶左右径（ $\overset{ˉ}{x}$ ± s，mm）	82.92 ± 36.59	57.40 ± 14.27	63.00 ± 29.03	F = 3.092	0.057
病灶前后径（ $\overset{ˉ}{x}$ ± s，mm）	62.17 ± 21.93	44.80 ± 8.39	54.40 ± 26.69	F = 2.453	0.099
CE硬度值（ $\overset{ˉ}{x}$ ± s，kPa）	15.77 ± 5.83	34.15 ± 9.28	50.80 ± 13.73	F = 45.991	＜ 0.001
周围肝脏硬度值（ $\overset{ˉ}{x}$ ± s，kPa）	7.42 ± 1.12	11.04 ± 7.89	9.25 ± 4.98	F = 1.160	0.326

指标	CE3型组（15例）	CE4型组（19例）	CE5型组（16例）	统计量	P值
年龄（ $\overset{ˉ}{x}$ ± s，岁）	41.73 ± 12.59	44.29 ± 16.66	52.93 ± 14.57	F = 2.378	0.105
性别［例（%）］				χ ²= 0.398	0.819^a
男	8（53.33）	12（63.16）	10（62.50）
女	7（56.66）	7（36.84）	6（37.5）
病灶数目［例（%）］				—	0.562^b
单个	12（80.00）	17（89.47）	15（93.75）
≥ 2	3（20.00）	2（10.53）	1（6.25）
病灶部位［例（%）］				—	0.976^b
左叶	3（20.00）	5（26.32）	5（31.25）
右叶	10（66.67）	12（63.15）	10（62.50）
左右叶	2（13.33）	2（10.53）	1（6.25）
病灶左右径（ $\overset{ˉ}{x}$ ± s，mm）	82.92 ± 36.59	57.40 ± 14.27	63.00 ± 29.03	F = 3.092	0.057
病灶前后径（ $\overset{ˉ}{x}$ ± s，mm）	62.17 ± 21.93	44.80 ± 8.39	54.40 ± 26.69	F = 2.453	0.099
CE硬度值（ $\overset{ˉ}{x}$ ± s，kPa）	15.77 ± 5.83	34.15 ± 9.28	50.80 ± 13.73	F = 45.991	＜ 0.001
周围肝脏硬度值（ $\overset{ˉ}{x}$ ± s，kPa）	7.42 ± 1.12	11.04 ± 7.89	9.25 ± 4.98	F = 1.160	0.326

References 30

［1］	Habibi B, Gholami S, Bagheri A, et al.Cystic echinococcosis microRNAs as potential noninvasive biomarkers: current insights and upcoming perspective［J］.Expert Rev Mol Diagn,2023,23(10):885-894.
［2］	中国医师协会外科医师分会包虫病外科专业委员会.肝两型包虫病诊断与治疗专家共识(2019版)［J］.中华消化外科杂志,2019,18(8):711-721.
［3］	Mihmanli M, Idiz UO, Kaya C, et al.Current status of diagnosis and treatment of hepatic echinococcosis［J］.World J Hepatol,2016,8(28):1169-1181.
［4］	Mcmanus DP, Gray DJ, Zhang WB, et al.Diagnosis, treatment, and management of echinococcosis［J］.BMJ,2012,344:e3866.
［5］	鄢靖欣, 邓满军, 樊羿辰, 等.中国西部地区近20年肝棘球蚴病的贝叶斯单臂Meta分析［J］.中国病原生物学杂志,2022,17(10):1164-1169.
［6］	Berto CG, Liou P, Coyle CM, et al.Surgical management of cystic echinococcosis of the liver［J］.Curr Opin Infect Dis,2023,36(5):348-352.
［7］	Stojković M, Weber TF, Junghanss T.Clinical management of cystic echinococcosis: state of the art and perspectives［J］.Curr Opin Infect Dis,2018,31(5):383-392.
［8］	Song L, Zhao L, Deng JQ, et al.Staging liver flbrosis in patients with chronic hepatitis B using two-dimensional shear wave elastography based on histopathological findings: a prospective multicenter study［J］.Quant Imaging Med Surg,2023,13(4):2376-2387.
［9］	王金环, 于国英, 祖红梅, 等.三维显微定量超声在乙型肝炎肝硬化患者病情评价中的应用［J/CD］中华实验和临床感染病杂志(电子版),2019,13(6):472-477.
［10］	Wang J, Wang Q, Yu G, et al.Correlation between liver stiffness measured by shear wave elastography and Child-Pugh classiflcation［J］.Ultrasound Med,2018,37(9):2191-2199.
［11］	Caenen A, Bézy S, Pernot M, et al.Ultrasound shear wave elastography in cardiology［J］.JACC Cardiovasc Imag,2024,17(3):314-329.
［12］	Hirooka M, Koizumi Y, Nakamura Y, et al.Spleen stiffness in patients with chronic liver disease evaluated by 2-D shear wave elastography with ultrasound multiparametric imaging［J］.Hepatol Res,2023,53(2):93-103.
［13］	Yang D, Wang Y, Zhuang B, et al.Nomogram based on highfrequency shear wave elastography (SWE) to evaluate chronic changes after kidney transplantation［J］.Eur Radiol,2023,33(2):763-773.
［14］	Tyloch DJ, Tyloch JF, Adamowicz J, et al.Comparison of strain and shear wave elastography in prostate cancer detection［J］.Ultrasound Med Biol,2023,49(3):889-900.
［15］	Xu HX, Yan K, Liu BJ, et al.Guidelines and recommendations on the clinical use of shear wave elastography for evaluating thyroid nodule［J］.Clin Hemorheol Microcirc,2019,72(1):39-60.
［16］	Wu H, Zhang S, Wang C, et al.Comparing the accuracy between shear wave elastography and strain elastography in the diagnosis of breast tumors: Systematic review and Meta-analysis［J］.Medicine(Baltimore),2022,101(18):e29139.
［17］	Cai RY, Lin ZH, Xu D, et al.The value of shear wave elastography in diagnosis and assessment of systemic sclerosis［J］.Rheumatol Adv Pract,2023,7(3):rkad075.
［18］	Ličen U, Kozinc Ž.Using shear-wave elastography to assess exerciseinduced muscle damage: a review［J］.Sensors (Basel),2022,22(19):7574.
［19］	Hu J, Lv Z, Dong Y, et al.Review of shear wave elastography in placental function evaluations［J］.Matern Fetal Neonatal Med,2023,36(1):2203792.
［20］	中华医学会放射学分会传染病学组, 中国医师协会放射医师分会感染影像专业委员会.肝包虫病影像学诊断专家共识［J］.中华放射学杂志,2021,69(1):5-11.
［21］	中华医学会超声医学分会介入超声学组弹性成像评估肝纤维化专家组.二维剪切波弹性成像评估慢性乙型肝炎肝纤维化临床应用指南［J］.中华超声影像学杂志,2017,26(11):921-927.
［22］	Gharbi HA, Hassine W, Brauner MW, et al.Ultrasound examination of the hydatid liver［J］.Radiology,1981,139(2):459-463.
［23］	WHO Informal Working Group.International classification of ultrasound images in cystic echinococcosis for application in clinical and fleld epidemiological settings［J］.Acta Trop,2003,85(2):253-261.
［24］	刘博姬, 徐辉雄.剪切波弹性成像在肌肉, 肌腱, 周围神经病变生物力学定量评估中的应用进展［J］.肿瘤影像学,2022,31(1):11-15.
［25］	高伟, 王浩, 马有良, 等.2018年青海省久治县人群肝棘球蚴病流行现状分析［J］.中国寄生虫学与寄生虫病杂志,2019,37(6):681-684.
［26］	Schweiger A, Ammann RW, Caridinas D, et al.Human alveolar echinococcosis after fox population increase, Switzerland［J］.Emerg Infect Dis,2007,13(6):878-882.
［27］	韩红, 陆清, 范培丽, 等.2023年中国肝病超声临床研究年度进展［J］.肿瘤影像学,2024,33(4):442-447.
［28］	张玉英, 马钦风, 陈鲜霞, 等.超声结合声触诊组织量化技术在肝包虫囊肿退行性变中的应用研究［J］.青海医学院学报,2015,38(4):272-275.
［29］	朱璐, 杨君茹, 何玲玲, 等.瞬时弹性成像在肝纤维化诊断中的应用研究进展［J/CD］.中国肝脏病杂志(电子版),2023,15(3):16-22.
［30］	王金环, 于国英, 徐辉雄, 等.实时剪切波弹性成像与食道静脉曲张程度的相关性研究［J］.中华肝脏病杂志,2015,23(7):502-506.

[1]	Boran Wang, Chunmei Qiao, Chunge Li, Xin Wang, Xiaolei Wang. Value of contrast-enhanced ultrasound in assessing progression of subclinical synovitis in patients with rheumatoid arthritis [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2024, 21(08): 802-808.
[2]	Yueying Hao, Yingxuan Mao, Yu Zhang, Jiaxu Wang, Linlin Han, Wenwen Kuang, Yao Meng, Xiuhua Yang. Ultrasound guided attenuation parameter for evaluating hepatic steatosis and predicting risk of cardiovascular disease [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2024, 21(08): 770-777.
[3]	Lin Ma, Chihan Peng, Xiaoxia Zhu, Hongxia Fan, Jiali Yang, Yan Luo. Quantitative evaluation of hepatic microcirculation perfusion in rats with different types of portal vein stenosis after 70% hepatectomy by contrast-enhanced ultrasound: an experimental study [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2024, 21(01): 83-89.
[4]	Fang Tan, Jiaojiao Yang, Yuqin Shen, Yanfeihai Li, Hairui Wang, Sihan Fan, Xueqin Ji. Evaluation of normal fetal heart morphology and systolic function by fetal heart quantification technique [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2023, 20(06): 598-604.
[5]	Qiang Zhu, Hang Yu, Mingxue Guo, Yi Xu, Minghui Zhu, Xinyu Ti, Wangping Li, Hao Xu, Yong Huang, Haihong Wu, Yunzhi Zhou, Ye Gu, Zhixin Liang, Zhen Yang, Liang′an Chen. Efficacy of bronchoscopic lung volume reduction with one-way valve：a multicenter retrospective study [J]. Chinese Journal of Laparoscopic Surgery(Electronic Edition), 2024, 17(06): 352-359.
[6]	Yushan Wang, Xiaofen Zheng, Hua Yu, Yuping Han, Xiaoling Ning. Correlation between corneal and conjunctival defect area and postoperative dry eye in patients with pterygium [J]. Chinese Journal of Ophthalmologic Medicine(Electronic Edition), 2023, 13(06): 344-349.
[7]	Fang Wang, Da Liu, Zhiwei Zuo, Jinping Sheng, Tingjin Chen, Rui Jiang. Meta-analysis of quantitative CT and dual energy X-ray absorptiometry in the diagnosis of osteoporo-sis [J]. Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition), 2024, 10(06): 363-371.
[8]	Qingju Zhang, Jianlin Xu, Yonggang Nan, Changbei Shi, Jinyun Niu. Analysis and application of standardized uptake value of the lumbar spine obtained from ^99mTc-MDP SPECT/CT quantitative bone imaging [J]. Chinese Journal of Clinicians(Electronic Edition), 2024, 18(03): 238-244.
[9]	Yansong Li, Tao Li, Yuanmingfei Zhang, Mouwang Zhou. Preliminary study of using virtual reality headsets to assist postoperative rehabilitation after total knee arthroplasty [J]. Chinese Journal of Clinicians(Electronic Edition), 2023, 17(06): 676-681.
[10]	Xu Zheng, Yanyan Han, Shan Gao, Chong Li. Analyzing the effect of protein expression profile characteristics after the intervention of Xiaoyan Decoction in human lung adenocarcinoma cells based on label-free quantitative proteomics technology [J]. Chinese Journal of Acupuncture and Moxibustion(Electronic Edition), 2024, 13(01): 18-23.
[11]	Chunlin Liu, Chang Liu, Dongyan Zhao, Duanping Li, Jianmei Liu, Qiulin Luo. Evaluation of measurement uncertainty for HBV DNA and HCV RNA by using internal quality control and proficiency testing data [J]. Chinese Journal of Clinical Laboratory Management(Electronic Edition), 2024, 12(02): 91-96.
[12]	Jianhui Ma, Qi Han, Shaoling Li. Accelerating rehabilitation surgical nursing pathway + quantitative evaluation to improve the nursing satisfaction of laparoscopic cholecystectomy elderly patients in operating room [J]. Chinese Journal of Gastroesophageal Reflux Disease(Electronic Edition), 2024, 11(01): 53-56.
[13]	Xiaoming Wu, Yangkui Zhai, Juan Wang, Shuo Zhang, Jie Xu, Congqing Pan. Association of fasting c-peptide and quantitative insulin sensitivity index with arteriosclerosis index of plasma in male patients with T2DM [J]. Chinese Journal of Obesity and Metabolic Diseases(Electronic Edition), 2024, 10(04): 288-294.
[14]	Xiaoyong Li, Haizhi Guo, Yang Zhao. Predictive value of QSM combined with SWI in neurological function of patients with acute ischemic stroke after endovascular treatment [J]. Chinese Journal of Cerebrovascular Diseases(Electronic Edition), 2024, 18(06): 549-555.
[15]	Jiaxi Han, Xiangmin Fan, Ning Su. The usage of digital technology evaluation methods in the diagnosis and treatment of neurologic movement disorders [J]. Chinese Journal of Cerebrovascular Diseases(Electronic Edition), 2023, 17(03): 275-279.

Please choose a citation manager

Content to export