声触诊组织量化技术联合超声BI—RADS分级鉴别乳腺良恶性肿物的价值

Value of virtual touch tissue quantification combined with BI-RADS for differential diagnosis of benign and malignant breast masses

目的探讨联合声触诊组织量化（VTQ）技术与超声BI—RADS分级对乳腺良恶性肿瘤的鉴别诊断价值。方法对138例患者142个BI—RADS分级为3级和4级的乳腺肿块进行VTQ检查，测量剪切波速度（SWV），与术后病理对照，分析乳腺良恶性的组间差异。结果VTQ诊断恶性乳腺肿块的ROC曲线下面积为0．91（95％CI：0．86～0．96）。以SWV3．4m／s为VTQ诊断界点，其诊断乳腺恶性肿瘤的敏感性、特异性、准确性及阳性预测值分别为82．7％、78．1％、82．4%和85．9%。应用超声BI—RADS分级判断乳腺恶性肿瘤的敏感性、特异性、准确性及阳性预测值分别为85．2％、78．7％、82．4％和84．1％。将VTQ（以3．4m／s为诊断界值）和超声BH-RADS分级联合诊断乳腺恶性肿瘤的敏感性、特异性、准确性及阳性预测值分别为96．3％、63．9％、82．4％和78．0％。结论VTQ技术和超声BI—RADS分级有助于乳腺肿块良恶性的鉴别诊断，二者联合应用可提高乳腺恶性肿瘤的检出率。

Objective To investigate the value of virtual touch tissue quantification combined with BI- RADS for differential diagnosis of benign and malignant breast lesions. Methods A total of 142 breast masses in 138 patients were detected by normal ultrasound and VTQ, and classified in grade 3 and grade 4 by BI-RADS. Share wave velocities（SWV） of lesions were measured, and the results were correlated with the pathologic results, the ROC curve were produced to find the cutoff value point of SWV to predict breast cancer. The difference between benign and malignant of masses was analyzed. Results VTQ in diagnosis of malignant breast masses of ROC area was 0.91（95%CI：0.86-0.96）. The cut-off point of SWV was determined as 3.4 m/s, the sensitivity, specificity, consistent rate and positive predictive value were 82.7 %, 78.1 %, 82.4%, 85.9%, respectively. The sensitivity, specificity, consistent rate and positive predictive value of BI-RADS were 85.2%, 78.7%,82.4%, 84.1%, respectively. The sensitivity, specificity, consistent rate and positive predictive value of VTQ （3.4 m/s as the cut-off point） combined with B1-RADS in diagnosis malignant breast masses were 96.3 %, 63.9 %, 82.4 % and 78.0%, respectively. Conelusions VTQ can help to differentiate benign from malignant breast diseases. The diagnostic value is improved when VTQ combined with BI-RADS.