声触诊组织量化技术在乳腺肿块定性诊断中的价值

Diagnostic value of virtual touch tissue quantification in the differential diagnosis of breast tumors

目的探讨声触诊组织量化(VTQ)技术在乳腺肿块良恶性鉴别诊断中的应用价值。方法应用VTQ技术对102例共107个乳腺肿块内部、肿块边缘及周围乳腺组织行剪切波速度(SWV)测量,分别记为SWVi、SWVb、SWVg。以病理结果为标准,比较乳腺良性组与恶性组SWV差异,绘制ROC曲线确定判断乳腺病灶良恶性的最佳界值。结果所有肿块的SWVi值明显高于SWVb和SWVg,SWVb值明显高于SWVg,差异均有统计学意义(P<0.01)。乳腺恶性组SWVi、SWVb分别为(6.70±1.75)、(4.58±1.38)m/s,良性组分别为(3.52±1.52)、(2.80±0.97)m/s,两组参数恶性组均高于良性组(P<0.01)。以SWVi值5.06m/s为界值诊断乳腺肿块良恶性的敏感性为83.7%、特异性为85.9%;以SWVb值3.51m/s为界值诊断肿块良恶性的敏感性为79.1%、特异性为81.2%。结论乳腺肿块内部与肿块边缘的SWV均有助于乳腺肿块良恶性的鉴别诊断。

Objective To explore the diagnostic value of virtual touch tissue quantification （VTQ） in the differential diagnosis of breast masses. Methods A total of 102 patients with 107 breast masses were examined by means of VTQ technique. The shear wave velocity （SWV） was measured within the lesion （SWVi）, in the boundary zone （SWVb） and in the normal glandular tissues （SWVg）. With results of pathological diagnosis as the gold standard, receiver operating characteristic （ROC） curve was used to evaluate the diagnostic value of VTQ and to find the optimal cut-off point in differentiating malignant from benign lesions. Results The SWVi was higher than SWVb and SWVg, and SWVb was higher than SWVg in both malignant and benign groups （ P 〈 0.05 ）. The SWVi and SWVb were （ 6.70 -＋ 1.75 ） and （4.58 _＋ 1.38） m/s, respectively in malignant lesions, and were （3.52 _＋ 1.52） and （2.80 ±0.97 ） m/s respectively in benign lesions, with significant differences between benign and malignant lesions （P 〈 0.01 ）. When the cutoff point of SWVi was determined as 5.06 m/s, the sensitivity was 83.7% and the specificity was 85.9%. When the cut-off point of SWVb was determined as 3.51 m/s, the sensitivity was 79. 1% and the specificity was 81.2%. Conclusion The SWVi and SWVb can help the differential diagnosis of breast tumors.