【摘要】 目的探讨声辐射力脉冲成像(ARFI)技术对乳腺恶性肿瘤的诊断价值。方法对127例患者130个乳腺肿块进行常规超声及ARFI检查,记录声触诊组织成像(VTI)与二维超声图像病灶面积比值(AR)及声触诊组织量化(VTQ)技术所测量的病灶声触诊剪切波速度(SWV),与术后病理对照,分析乳腺良恶性的组间差异。结果 VTQ对恶性乳腺肿块诊断价值的ROC曲线下面积为0.90(95%CI:0.86~0.96)。以SWV=2.9m/s为VTQ诊断界点诊断乳腺恶性肿瘤的灵敏度、特异度、准确度及阳性预测值分别为93.2%、71.9%、83.8%和81.0%。AR对恶性乳腺肿块诊断价值的ROC曲线下面积为0.84(95%CI:0.78~0.91)。以1.27为诊断界点,判断乳腺恶性肿瘤的灵敏度、特异度、准确度及阳性预测值分别为76.7%、82.5%、79.2%和84.8%。将VTQ(以2.9m/s为诊断界值)和AR(1.27为诊断界值)并联诊断乳腺恶性肿瘤的灵敏度、特异度、准确度及阳性预测值分别为97.3%、61.4%、81.5%和76.3%。结论 ARFI有助于乳腺肿块良恶性的鉴别诊断,VTQ诊断乳腺恶性肿块灵敏度优于VTI,二者联合应用可使超声诊断乳腺恶性肿块的灵敏度进一步提高。更多还原

【Abstract】 Objective To evaluate the clinical application value in the diagnosis of malignant breast lesions by acoustic radiation force impulse(ARFI).Methods A total of 130 breast lesions in 127 patients were detected by normal ultrasound test and ARFI.The area ratio(AR)of the lesions in normal ultrasonography to virtual touch tissue imaging(VTI)and the shear wave velocities(SWV)of lesions were measured,and the results were correlated with the pathologic results,the ROC curve were produced to find the cut-off value point of AR and SWV to predict breast cancer.The difference between benign and malignant of breast lesions was analyzed.Results VTQ in diagnosis of malignant breast masses of ROC area was 0.90(95%CI:0.86-0.96).The cut-off point of SWV was 2.9m/s,the sensitivity,specificity,consistent rate and positive predictive value was 93.2%,71.9%,83.8%,81%.AR in diagnosis of malignant breast masses of ROC area was 0.84(95%CI:0.78-0.91).The cut-off point of AR was 1.27,The sensitivity,specificity,consistent rate and positive predictive value of AR was 76.7%,82.5%,79.2%,84.8%.The sensitivity,specificity,consistent rate and positive predictive value of SWV(2.9m/s as the cut-off point)combine with AR(1.27 as the cut-off point)in diagnosis malignant breast masses was 97.3%,61.4%,81.5%,76.3%.Conclusions ARFI can help to differentiate benign from malignant breast diseases.The sensitivity of SWV is better than AR,and the sensitivity is improved when VTQ combine with AR.更多还原