摘要
目的评估声辐射力脉冲成像(acoustic radiation force impulse imaging,ARFI)技术对乳腺结节良恶性鉴别诊断价值。方法对87例女性患者的95个乳腺结节行ARFI声触诊组织成像(virtual touch tissue imaging,VTI)及声触诊组织定量(virtual touch tissue quantification,VTQ)检查。以VTI弹性分级≥Ⅳ级判断为恶性,VTQ中计算乳腺结节及结节边缘区的剪切波速度(shear wave velocity,SWV)最大值、平均值及最小值。结果以VTI弹性分级乳腺评估结节良恶性准确率为70. 53%。根据受试者工作特征曲线(receiver operating characteristic,ROC)得出乳腺结节内部、结节边缘区SWV的最大值、平均值及最小值的最佳诊断截断值分别为5. 82、4. 02、3. 23 m/s和3. 28、1. 90、1. 06 m/s,其准确率分别为81. 05%、81. 05%、70. 53%和75. 79%、77. 89%、74. 74%。联合VTI及VTQ诊断的最高敏感性和准确率分别为97. 73%和73. 68%。结论 VTI及VTQ对乳腺结节良恶性鉴别诊断均有较高价值,检测乳腺结节边缘区的SWV值可作为乳腺良恶性结节的鉴别诊断指标之一。联合VTI及VTQ诊断能提高恶性肿瘤的检出敏感性。
Objective To evaluate the diagnostic value of acoustic radiation force impulse imaging(ARFI)in differentiating benign and malignant breast lesions.Methods Ninety-five breast lesions of 87 female patients underwent ARFI examination,including virtual touch tissue imaging(VTI)and virtual touch tissue quantification(VTQ).The grade level of VTI≥Ⅳwas considered to be malignant nodule.The maximum,mean and minimum numerical value of shear wave velocity(SWV)of VTQ within breast lesions as well as within the marginal area between lesions and breast tissue were calculated.Results The accuracy of VTI elastic grade in breast lesions was 70.53%.Based on the receiver operating characteristic curve,the optimal cut-off values of the maximum,mean and minimum values of SWV within breast lesions as well as within the marginal area between lesions and breast tissue were 5.82 m/s,4.02 m/s,3.23 m/s and 3.28 m/s,1.90 m/s,1.06 m/s,respectively.The diagnostic accuracy of maximum,mean and minimum values of SWV within breast lesions as well as within the marginal area between lesions and breast tissue were 81.05%,81.05%,70.53%and 75.79%,77.89%,74.74%,respectively.Maximum sensitivity and accuracy of combining diagnosis between VTI and VTQ were 97.73%and 73.68%.Conclusion Both VTI and VTQ could achieve high diagnostic value for breast lesions.SWV of the marginal area between lesions and breast tissue could be a valuable differentiating index.The combination of VTI and VTQ could improve the sensitivity of detecting malignant breast tumor.
作者
周佩
段韵
向慧娟
ZHOU Pei;DUAN Yun;XIANG Huijuan(Department of Ultrasound,the General Hospital of Central Theater Command,Wuhan Hubei 430070,China)
出处
《华南国防医学杂志》
CAS
2018年第12期846-850,共5页
Military Medical Journal of South China
关键词
乳腺结节
声辐射力脉冲成像
剪切波速度
声触诊组织成像
声触诊组织定量
Breast lesions
Acoustic radiation force impulse imaging
Shear wave velocity
Virtual touch tissue imaging
Virtual touch tissue quantification
