声脉冲辐射力弹性成像声触诊组织定量技术鉴别诊断乳腺纤维瘤与乳腺黏液癌的价值

Effect of acoustic pulse radiation elastography and acoustic palpation tissue quantification in differential diagnosis of breast fibroma and mucinous carcinoma of breast

目的探讨超声诊断中的声触诊组织定量(VTQ)技术在鉴别诊断乳腺纤维瘤与乳腺黏液癌的应用价值。方法对我院2012年11月~2015年12月手术前行超声弹性成像并进行手术治疗的156例乳腺结节患者的临床资料进行回顾性分析,其中17例是单纯型乳腺黏液癌,25例是混合型乳腺黏液癌,61例是乳腺纤维腺瘤,53例乳腺癌侵袭性导管瘤。这156例乳腺结节患者的手术前声触诊组织定量检测结果与术后病理学结果结果对照评价其诊断结果。结果四组不同病理类型乳腺结节声触诊组织定量VTQ测量值差异有统计学意义(P<0.05)。声触诊组织定量在良性结节和恶性乳腺黏液癌判断的误诊率为2%(1/42),在单纯型黏液癌误诊率为5.9%(1/17),在混合型黏液癌误诊率0(0/25),声触诊组织定量技术显著提高乳腺黏液癌的诊断的准确率。从声触诊组织定量测量值水平比较,黏液性癌并不与质地柔软的肿瘤相似,而是有一定的弹性硬度。结论声触诊组织定量技术(VTQ)在乳腺纤维瘤与乳腺黏液癌的鉴别诊断中具有较高的应用价值。

Objective To investigate the value of acoustic tissue quantification （VTQ） in the differential diagnosis of breast fibroadenoma and mucinous carcinoma of the breast. Methods Clinical data of 156 patients with breast nodules who underwent preoperative elastography and surgical treatment from November 2012 to December 2015 in our hospital were retrospectively analyzed,including 17 cases of simple type of breast mucinous carcinoma,25 cases of mixed type of breast mutinous carcinoma,61 cases of breast fibroadenoma,53 cases of breast invasive ductal carcinoma.The results of preoperative quantitative diagnosis of breast palpation and the postoperative pathological findings in 156 patients with breast nodules were compared and evaluated. Results The difference of four groups with different pathological types of breast nodules which were detected by palpation quantitative VTQ was statistically significant（P 〈 0.05）.The misdiagnosis rate of acoustic palpation tissue quantification in benign nodules and malignant mucinous carcinomas was 2%（1/42）.The misdiagnosis rate in pure mucinous carcinoma was 5.9%（1/17）,and the misdiagnosis rate in mixed type mucinous carcinoma was 0（0/25）.The accuracy of acoustic palpation tissue quantification technique in breast mucinous carcinoma diagnosis is improved significantly.Compared with the quantitative value of tissue measurements by acoustic palpation,mucinous carcinoma is not similar to a soft tumor but rather has a certain degree of elasticity. Conclusion Acoustic tissue quantification （VTQ） in the differential diagnosis of breast fibroma and mucinous carcinoma of breast has high value.