声脉冲辐射力弹性成像对乳腺实性病灶良恶性的诊断价值

Diagnostic Value of Acoustic Radiation Force Impulse Elastography in Benign or Malignant Solid Breast Masses

目的评估声脉冲辐射力(acoustic radiation force impulse,ARFI)弹性成像技术对乳腺实性病变良恶性鉴别诊断价值。方法对62例患者的62个乳腺实性病灶行ARFI声触诊组织成像(virtual touch tissue imaging,VTI)及声触诊组织定量(virtual touch tissue quantitfication,VTQ)两种技术检查。以VTI弹性分级≥IV级判断为恶性病灶,VTQ中计算病灶剪切波速度(shear wave velocity,SWV)平均值。结果根据受试者工作特征(receiver operating characteristic,ROC)曲线得出乳腺良恶性病灶SWV平均值的最佳诊断截断值为4.12 m/s,曲线下面积(area under curve,AUC)分别为0.793,其灵敏度、特异度、准确率分别为76.92%、88.89%、83.87%;以VTI弹性分级≥IV级判断乳腺病灶为恶性,其灵敏度、特异度、准确率分别为76.92%、86.11%、82.26%,联合VTI及VTQ诊断的灵敏度、特异度及准确率分别92.30%,94.44%,93.55%。结论 ARFI技术定性及定量评价乳腺病灶的良恶性,对良恶性鉴别有较高诊断价值,两者结合应用对乳腺实性病灶的鉴别有较大帮助。

Objective To evaluate the values of acoustic radiation force impulse （ARFI） technology in differentia- ting between benign and malignant solid breast masses. Methods Sixty-two patients with 62 solid breast masses were accepted virtual touch tissue imaging （VTI） and virtual touch tissue quantification （VTQ） examination of ARFI. The elastic classification of VTI ≥IV was considered as malignant lesions, and the average shear wave velocity （SWV） of lesion tissues was calculated. Results According to the receiver operating characteristic （ROC） curve, the best diagnostic cut-off values of SWV mean was 4. 12 m/s, area under curve （AUC） was 0. 793, sensitivity was 76. 92%, specificity was 88. 89%, and accuracy was 83.87%. The elasticity of VTI≥IV was considered to be malignant,the sensitivity, specificity and accuracy were 76. 92%, 86. 11%, 82. 26%, respectively. Conbined VTI with VTQ, the sensitivity, specificity and accuracy were 92. 30%, 94. 44%, 93. 55 %, respectively. Conclusion ARFI quantitative assessment has high diagnostic value on identification of benign and malignant breast lesions. It＇s helpful on identifying breast solid lesions by combining VTI with VTQ.