摘要
目的探讨声辐射力触诊成像(ARFI)技术在良恶性乳腺肿块鉴别诊断中的应用价值。方法选取乳腺肿块患者60例共62个肿块,进行声触诊组织成像(VTI)检查,随后进行声触诊组织定量(VTQ)检查,测量各乳腺肿块的剪切波速度(SWV)。以术后病理结果为对照,绘制ROC曲线,明确VTI、VTQ、VTI联合VTQ诊断乳腺肿块良恶性的最佳切点。结果62个肿块术后病理结果证实良性肿块42个,恶性肿块20个。应用VTI检查,对比病理组织学检查结果绘制ROC曲线,AUC为0.920;以VTI≥4级为最佳诊断切点,此时灵敏度为0.850,特异度0.878。应用VTQ检查,恶性肿块的SWV显著快于良性肿块(P<0.05),对比病理组织学检查结果绘制ROC曲线,AUC为0.858,以SWV>4.12m/s为最佳诊断切点,此时灵敏度为0.900,特异度为0.829。VTI联合VTQ检查,对比病理组织学检查结果绘制ROC曲线,AUC为0.983,以联合预测概率>0.559 2为最佳诊断切点,此时灵敏度为0.950,特异度0.951。VTQ联合VTI检查中联合预测概率诊断乳腺良恶性肿块的ROC AUC显著大于VTQ检查中SWV诊断乳腺良恶性肿块的ROC AUC(P=0.040)和VTI检查中VTI分级诊断乳腺良恶性肿块的ROC AUC(P=0.042),后两者间ROC AUC的差异无统计学意义(P=0.424)。结论 ARFI技术对乳腺肿块良恶性的鉴别诊断具有一定的诊断价值,VTI与VTQ联合应用可提高鉴别诊断水平。
Objective To investigate the value of acoustic radiation force impulse （ARFI） in the differential diagnosis of benign and malignant breast mass. Methods Totally 60 patients with breast masses （62 lesions） received virtual touch imaging （VTI） followed by virtual touch quantification （VTQ）. Shear wave velocity （SWV） of the masses was measured. Corhpared with postoperative Pathological results, a receiver operating characteristic （ROC） curve was drawn to determine the optimized cut-off of the VTQ, VTI, VTI ＋ VTQ in differential diagnosis of breast benign and malignant tumors. Results Postoperative pathological results showed that there were 42 benign lesions and 20 malignant lesions. The AUC of the ROC curve was 0. 920 by using VTI. The sensitivity and specificity were 0. 850 and 0. 878 respectively, when the optimized diagnosis cut-off of VTI was 4 and more. When VTQ was performed, the SWV of malignant masses was significantly faster than that of benign ones （P〈0.05）, and the AUC of the ROC curve was 0. 858. The sensitivity and specificity were 0. 900 and 0. 829 respectively, when the optimized diagnosis cut-off of SWV was more than 4. 12 m/s. The AUC of the ROC curve was 0. 983 by using VTI ＋ VTQ. The sensitivity and specificity were 0. 950 and 0. 951 respectively, when the optimized diagnosis cut-off of VTI ＋ VTQ was more than 0. 559 2. The ROC-AUC of VTI ＋ VTQ was significantly greater than that of VTQ SWV （P = 0. 040） and VTI classification （P = 0. 042） in the diagnosis of benign and malignant breast tumors. But there was no significant difference in the ROC AUC between SWV and VTI （P =0.424）. Conclusion ARFI has a certain reference value in differential diagnosis of benign and malignant breast tumors. The application of VTI and VTQ can be used as an effective method to improve differential the diagnosis of breast tumors.
作者
徐芳
支芬燕
罗伟华
陈道芳
史登刚
姚宏
郭强
XU Fang;ZHI Fenyan;LUO Weihua;CHEN Daofang;SHI Denggang;YAO Hong;GUO Qiang(Department of Ultrasound in Medicine, Jinshan Branch of the Sixth People ＇ s Hospital of Shanghai, Shanghai 201599, China)
出处
《上海医学》
CAS
北大核心
2018年第3期165-168,共4页
Shanghai Medical Journal
基金
上海市第六人民医院医疗集团科研课题(2013-3)
关键词
声辐射力触诊成像
声触诊组织成像
声触诊组织定量
乳腺肿块
Acoustic radiation force impulse
Virtual touch imaging
Virtual tissue quantification
Breast masses
