弹性应变比率及VTQ参数对BI-RADS4类乳腺肿块的定性诊断价值

Value of Strain Ratio and VTQ Parameters in the Qualitative Diagnosis of BI-RADS4 Breast Lesions

目的:探究弹性应变比率(SR)及声触诊组织量化技术(VTQ)参数对BI-RADS4类乳腺肿块的定性诊断价值。方法:选取南昌市人民医院2020年7月-2022年3月行常规超声检查、发现乳腺实性占位并经病理证实为BI-RADS4类乳腺肿块的107例患者为研究对象。所有患者均接受超声弹性成像检查和VTQ检查,比较不同性质乳腺肿块的SR、剪切波速度(SWV)。以病理结果为“金标准”,分析SR、SWV及其联合检查对BI-RADS4类乳腺肿块的定性诊断效能。结果:107例患者经手术病理检查共检出118个病灶,包括良性病灶73个,恶性病灶45个。乳腺良性肿块的SR、SWV均低于乳腺恶性肿块(P<0.05)。ROC曲线分析结果显示,SR、SWV诊断BI-RADS4类乳腺恶性肿块的AUC值为0.867、0.839,差异无统计学意义(P>0.05)。分别以SR、SWV的最佳临界值为诊断标准,超声弹性成像检出恶性肿块48个,良性肿块70个;VTQ技术检出恶性肿块55个,良性肿块63个;SR、SWV及其联合诊断结果与病理结果一致性较高(Kappa=0.805、0.587、0.823)。联合诊断乳腺恶性肿块的特异度、准确率和阳性预测值均高于SWV(P<0.05)。结论:SR和VTQ参数SWV在BI-RADS4类乳腺肿块的定性诊断中具有一定应用价值,与病理检查结果一致性较高,二者联合应用可进一步提高诊断效能。

Objective:To investigate the value of strain ratio(SR)and virtual touch quantification(VTQ)parameters in the quantitative diagnosis of BI-RADS4 breast lesions.Method:A total of 107 patients who were diagnosed with solid breast lesions by conventional ultrasound and confirmed as BI-RADS4 breast lesions by pathology in Nanchang People's Hospital from July 2020 to March 2022 were selected as the subjects.All patients received strain ultrasound elastography and VTQ examination,SR and shear wave velocity(SWV)were compared between patients with different breast lesions.Used the pathological results as the"gold standard",the quantitative diagnostic efficacy of SR,SWV and their combined examination for BI-RADS4 breast masses were analyzed.Result:Surgical and pathological results showed that there were 118 lesions in the 107 patients,including 73 benign lesions and 45 malignant lesions.SR and SWV of benign lesions were lower than those of malignant lesions(P<0.05).ROC curve analysis found that the AUC values of SR and SWV in the diagnosis of BI-RADS4 breast lesions were 0.867 and 0.839,there was no significant difference(P>0.05).With the best cut-off values of SR and SWV as diagnostic criteria,ultrasound elastography detected 48 malignant lesions and 70 benign lesions,while VTQ detected 55 malignant lesions and 63 benign lesions.The diagnostic results of SR,SWV and their combination were highly consistent with pathological results(Kappa=0.805,0.587,0.823).The specificity,accuracy and positive predictive value of combined diagnosis of breast malignant mass were higher than SWV(P<0.05).Conclusion:Both SR and SWV are helpful for quantitative diagnosis of BI-RADS4 breast lesions,and the diagnostic results are highly consistent with pathological results,combined use can improve the diagnostic performance.