声辐射力冲击成像对乳腺结节性质的鉴别诊断价值

Value of acoustic radiation force impulse imaging in the differential diagnosis of breast lesions

目的探讨应用声辐射力冲击成像(ARFI)技术对乳腺良性与恶性结节病灶的鉴别诊断价值。方法以33例<10 mm恶性乳腺结节患者及同期20例良性乳腺结节患者为研究对象,利用ARFI的声触诊组织成像(VTI)定性结节范围和声触诊组织定量(VTQ)量化结节的剪切波速度,与临床病理结果比较,分析良恶性病灶的ARFI-VTI和ARFI-VTQ参数差异。结果 ARFI-VTI能定性病灶结节范围,病灶结节在VTI图中与二维图中的面积比参数在良恶性组间差异有显著统计学意义,恶性组>1,良性组≤1(P<0.01);ARFI-VTQ测值在良恶性结节间差异有显著统计学意义,良性结节组VTQ剪切波速度为(2.67±1.63)m/s,恶性结节组VTQ剪切波速度为(5.24±2.72)m/s(P<0.01);对小结节型乳腺癌的诊断与病理诊断符合率为97.0%,特异度为80.0%。结论 ARFI检查对结节<10 mm的乳腺良恶性肿瘤具有鉴别诊断价值,值得临床应用推广。

Objective To assess the clinical value of acoustic radiation force impulse（ARFI） parameters on ultrasonography in the differential diagnosis of breast lesions.Methods Fifty-three breast lesions（〈10 mm） were enrolled and divided into two groups. There were 33 malignant lesions in one group,and 20 benign lesions in the other group.ARFI was applied to measure the virtual touch tissue imaging（VTI） and virtual touch tissue quantification（VTQ） in every lesion.The date were compared with pathological results.Results The distributed range of lesions in ARFI-VTI was clear.The area ratio of lesions in VTI images versus in B-mode images was statistically different between the two groups,with area ratio〉l in malignant lesions,and≤1 in benign lesions（P〈0.01）; The values of ARFI VTQ were higher in malignant lesions than in benign ones.In malignant lesions shear wave velocity was （5.24±2.72） m/s,and in benign lesions shear wave velocity was（2.67±1.63） m/s（P〈0.01）.Compared to pathological results the diagnostic accuracy of small malignant lesions was 97.0%,and specifity was 80.0%.Conclusion ARFI can measure the value of VTI and VTQ in breast small lesions（〈10 mm）,provideing helpful information in the differential diagnosis of malignant and benign lesions.