两种声触诊组织定量技术对不同大小乳腺良恶性肿块的诊断价值

Diagnostic value of two virtual touch tissue quantification techniques in benign and malignant masses of breast with different sizes

目的比较声触诊组织量化(VTQ)技术、声触诊组织量化成像(VTIQ)技术对不同大小乳腺良恶性肿块的诊断价值。方法选取行手术切除并经病理证实的219个乳腺肿块,根据肿块的最大径分为3组:5~10 mm(S1组)、11~20 mm(S2组)、21~39 mm(S3组)。术前经VTQ检查获得剪切波速度(SWV)值(SWVVTQ),经VTIQ检查获得SWV最大值(SWVmax)和SWVmax与同深度周围腺体SWV的比值(SWVratio)。以病理结果为金标准,比较两种声触诊组织定量技术对不同大小乳腺良恶性肿块的诊断价值。结果 3组组内乳腺良、恶性肿块SWVVTQ、SWVmax、SWVratio比较差异均有统计学意义(P均<0.001)。3组乳腺恶性肿块SWVVTQ(F=35.037,P<0.001)、SWVmax(F=30.771,P<0.001)、SWVratio(F=6.866,P=0.002)比较总体差异有统计学意义,除S2与S3组间SWVratio差异无统计学意义(P=0.752),余两两组间比较差异均有统计学意义(P均<0.05)。VTQ及VTIQ技术诊断S2和S3组乳腺恶性肿块的AUC均>0.90。S1组SWVVTQ与SWVmax及SWVratio的AUC比较,差异有统计学意义(P<0.05);S2组和S3组SWVVTQ、SWVmax及SWVratio的AUC比较差异均无统计学意义(P均>0.05)。结论对于最大径>10 mm的乳腺肿块,VTQ、VTIQ技术的诊断价值相当,均可较好地应用于良恶性的鉴别诊断;对于最大径≤10mm的乳腺良恶性肿块的鉴别,VTIQ技术较VTQ技术具有更高的诊断价值。

Objective To compare the diagnostic value of virtual touch tissue quantification(VTQ) technique and virtual touch tissue imaging quantification(VTIQ) technique in benign and malignant breast masses with different sizes. Methods Totally 219 breast masses were selected and confirmed by pathology. According to the largest diameter, all masses were divided into three groups: 5-10 mm(S1 group), 11-20 mm(S2 group) and 21-39 mm(S3 group). The shear wave velocity(SWV) value(SWVVTQ) was obtained by VTQ examination, the SWV maximum value(SWVmax) and SWVmax to the SWV of the surrounding gland in the same depth(SWVratio) were obtained by VTIQ examination before surgery. The pathological results were used as the criteria to compare the diagnostic value of two virtual touch tissue quantification techniques for benign and malignant breast masses of different sizes. Results There were significant differences in SWVVTQ, SWVmax, SWVratio between the benign and malignant breast masses in 3 groups(all P<0.001). There were statistically significant differences of SWVVTQ(F=35.037, P<0.001), SWVmax(F=30.771, P<0.001), and SWVratio(F=6.866, P=0.002) among the 3 groups of breast malignant masses, except that there was no significant difference in SWVratio between the S2 group and S3 group(P=0.752), the difference between the any other two groups was statistically significant(all P<0.05). The AUC of VTQ and VTIQ for the diagnosis of S2 group and S3 group breast malignant masses were all >0.90. The difference of AUC between SWVVTQ and SWVmax, SWVratio was statistically significant in S1 group(P<0.05). There was no significant difference in AUC of SWVVTQ, SWVmax and SWVratio between S2 group and S3 group(P>0.05). Conclusion For breast masses with the largest diameter >10 mm, the diagnostic value of VTQ and VTIQ techniques are equivalent. For breast masses with the largest diameter ≤10 mm, VTIQ technology has higher diagnostic value than VTQ technology in the diagnosis of benign and malignant breast masses.