声脉冲辐射力成像技术在鉴别乳腺良恶性肿瘤中的价值
Acoustic Radiation Force Impulse for Differential Diagnosis of Benign or Malignant Breast Tumors
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摘要: 目的 探讨声脉冲辐射力成像技术(acoustic radiation force impulse,ARFI)在乳腺良恶性肿瘤鉴别诊断中的价值。 方法 采用西门子公司ACUSON S2000超声诊断仪, 对108例共129个病灶进行检查，先行常规超声检查，然后应用组织弹性成像技术,评价组织硬度并评分，再进入ARFI诊断技术中的声触诊组织量化(virtual touch tissues quantification,VTQ)模式,测量肿瘤的横向剪切波速度。所有病例均经术后穿刺活检或病理诊断证实(其中良性86例，恶性43例)。结果 当诊断界值在3.58 m/s时，ARFI在诊断乳腺占位性病变中的特异性、敏感度、准确度分别为91.9%,93.0%,92.2%。良恶性乳腺肿瘤VTQ值差异存在统计学意义(P＜0.01)。良性肿瘤内部的平均VTQ值为（2.43±0.35）m/s,恶性肿瘤内部的平均VTQ值为（5.28±2.37）m/s, 其中5例恶性肿瘤的VTQ值＞10 m/s。结论 ARFI在判断乳腺良恶性肿瘤中具有较高的特异性、敏感度、准确度。VTQ值可定量判断乳腺病灶的硬度,能够更好地对乳腺肿瘤的良恶性作出诊断。Abstract: Objective To explore the value of acoustic radiation force impulse(ARFI) technology in differential diagnosis of benign or malignant breast tumors. Methods Using Siemens ACUSON S2000, 108 cases with a total of 129 focus (benign 86, malignant 43) were studied with conventional ultrasound examination firstly. Organization hardness and scores was evaluated by real-time tissue elastography. Transverse shear wave velocity of the tumors was measured by VTQ of ARFI. All cases were proved by surgery or biopsy. Results When the threshold was 3.58 m/s, the specificity, sensitivity and accuracy of ARFI in the diagnosis of breast tumors were 91.9%, 93.0% and 92.2%, respectively. There was signifi cant difference of VTQ values between benign and malignant breast tumor (P＜0.01). The mean VTQ value of benign and malignant tumors was (2.43 ±0.35) m/s and (5.28 ±2.37) m/s, respectively. And VTQ value was more than 10.00 m/s in 5 cases with malignant tumor. Conclusion ARFI in differential diagnosis of benign or malignant breast tumors has high specifi city, sensitivity and accuracy. VTQ value can be used to judge the hardness of breast focus and better in differential diagnosis of benign or malignant breast tumors.
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