声脉冲辐射力成像对乳腺肿块鉴别诊断价值的初步研究

Acoustic radiation force impulse elastography in differential diagnosis of breast masses

目的 探讨声脉冲辐射力成像（ARFI）在乳腺良恶性肿块鉴别诊断中的应用价值.方法 应用ARFI技术对86例患者共107个乳腺肿块进行声触诊组织成像（VTD及声触诊组织量化（VTQ）检查,VTI对肿块硬度进行评分,找出肿块VTI图与灰阶图面积比预测乳腺恶性肿瘤的最佳截点,VTQ测量乳腺肿块内部剪切波速度（SWV）.结果 VTI硬度评分恶性组4分以上的出现率明显高于良性组（P＜0.01）.以VTI图与灰阶图面积比1.53为截点诊断乳腺恶性肿瘤的敏感性、特异性分别为95.7％、92.5％.恶性组SWV明显高于良性组（P＜0.001）.结论 乳腺良恶性肿块的VTI硬度评分、VTI图与灰阶图面积比及肿块内部SWV有助于乳腺肿块良恶性的鉴别诊断.

Objective To explore the application value of acoustic radiation force impulse（ARFI） in the differential diagnosis of breast lesions.Methods Eighty six patients with 107 lesions were performed ARFI elastography.The stiffness of the masses in virtual touch tissue image（VTI） were scored.The pathological diagnosis as the gold standard,drawed the ROC curve to find the cut off point of area ratio to predict breast cancer.Shear wave velocity（SWV） within the breast masses were measured using virtual touch tissue quantification（VTQ） technique.Results The elastography hardness score higher than grade 4 was mainly distributed in the malignancies compared to benign lesions（ P 〈0.01）.1.53 as the cut-off point of area ratio,sensitivity and specificity of diagnosing breast cancer were 95.7 %,92.5 %.SWV of malignant group higher than benign group,the difference was statistically significant （P 〈 0.001 ）.Conclusions Hardness score in VTI imaging,area ratio of benign and malignant lesions,SWV within the breast masses can help the differential diagnosis of breast lesions.