声触诊组织量化技术诊断乳腺纤维腺瘤的临床观察

Virtual touch tissue quantification in diagnosis of breast fibroadenoma

目的探讨声触诊组织量化(VTQ)技术对乳腺纤维腺瘤的诊断价值。方法 166例经手术病理组织学证实的乳腺纤维腺瘤患者,共198个结节,术前均行常规超声及VTQ检查,观察乳腺纤维腺瘤的VTQ特征,记录有数值结节的VTQ值,以平均剪切波速度(Vm)绘制ROC曲线,寻找判断指标。结果在198个结节中,有25个结节VTQ值缺失,用有效结节的Vm绘制ROC曲线,其曲线下面积>0.80,以2.25 m/s为临界点判定乳腺纤维腺瘤的敏感度、特异度和准确性分别为86.1%、70.2%和86.3%;乳腺纤维腺瘤内血流信号对其VTQ值有一定的影响,无血流信号肿块的VTQ值大于有血流信号的肿块(P<0.01);乳腺纤维腺瘤的VTQ值在感兴趣区不同深度与不同直径间的差异均无统计学意义(P>0.05)。结论 VTQ技术对乳腺纤维腺瘤的诊断具有重要价值。

Objective To explore the value of virtual touch tissue quantification （VTQ） in the diagnosis of breast fibroadeno- ma. Methods One hundred sixty-six cases with 198 nodules of breast fibroadenoma confirmed by pathology underwent routine preoper- ative ultrasound and VTQ examination. The valid VTQ value was recorded and ROC curve was drawn using the average shear wave ve- locity （Vm） as to seek the diagnostic cutoff. Results Among the 198 nodules, VTQ value of 25 nodules was absent. We found that the Vm could be used to diagnosis the breast fibroadenoma with the area under the curve greater than 0. 80. The sensitivity, specificity and accuracy of Vm in distinguishing fibroadenoma were 86. 1%, 70. 2%, 86. 3% when using 2. 25 m/s as the cutoff. The blood flow signal of breast fibroadenoma had some affection on the VTQ value. The VTQ of fibroadenoma without blood flow signal was higher than that of fibroadenoma with blood flow signal（ P〈0.01 ）. There were no significant difference of VTQ value among breast fibroadenoma with dif- ferent diameters and different depths （P〉0.05）. Conclusion VTQ has great value in the diagnosis of breast fibroadenoma.