| 林梅影,金占强.声脉冲辐射力成像技术鉴别诊断BI-RADS 4类病灶[J].中国医学影像技术,2014,30(6):872~876 |
| 声脉冲辐射力成像技术鉴别诊断BI-RADS 4类病灶 |
| Acoustic radiat ion force impulse elastography in differential diagnosis of BI-RADS category 4 breast lesions |
| 投稿时间：2013-11-13 修订日期：2014-01-26 |
| DOI： |
| 中文关键词: 超声检查 乳腺肿瘤 诊断,鉴别 |
| 英文关键词:Ultrasonography Breast neoplasms Diagnosis,differential |
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| 中文摘要: |
| 目的 评价声脉冲辐射力弹性成像（ARFI）技术鉴别诊断乳腺影像报告与数据系统/超声诊断（BI-RADS-US）4类病变良恶性的价值。方法 选取120例乳腺疾病患者，对152个乳腺BI-RADS-US 4类病灶进行ARFI检查，利用声触诊组织定性成像（VTI）判断肿块的性质、范围，并计算病灶在弹性图像与灰阶图像上的面积比；以声触诊组织定量（VTQ）技术测量病灶与同层次周围乳腺组织的剪切波速度（SWV）比值。结果 乳腺良、恶性病灶在弹性图像与灰阶图像上的面积比分别为1.13±0.19和1.95±0.62（P<0.001），良、恶性病灶与同层次周围乳腺组织的SWV比值分别为2.38±1.29 m/s和5.82±1.76 m/s（P<0.001）；面积比和SWV比值的ROC曲线下面积分别为0.917和0.938，差异无统计学意义（P>0.05），95%可信区间面积比为86.80%~96.50%，SWV比为89.60%~97.90%。以面积比值1.43和SWV比值3.69作为最佳诊断界值，则ARFI诊断乳腺恶性肿瘤的准确率、敏感度、特异度、阳性预测值分别为89.47（136/152）%、76.19%（48/63）、98.88%（88/89）、97.96%（48/49）和90.13%（137/152）、80.95%（51/63）、96.63%（86/89）和94.44%（51/54）。结论 ARFI技术可有效提高鉴别诊断良恶性BI-RADS-US 4类乳腺病变的准确率。 |
| 英文摘要: |
| Objective To observe the value of acoustic radiation force impulse (ARFI) in differential diagnosis of benign and malignant breast imaging reporting and data system/ultrasound 4 (BI-RADS-US 4) breast lesions. Methods Totally of 120 patients with 154 BI-RADS-US 4 breast lesions confirmed by conventional ultrasound underwent ARFI. Virtual touch tissue imaging (VTI) was used to estimate the properties and extent of breast tumors, and to calculate the area ratio of lesions in elastic image and gray-scale image. Virtual touch tissue quantification (VTQ) was used to measure shear wave velocity (SWV) ratio of lesions and surrounding breast tissue at the same level. Results The area ratio of benign and malignant breast lesions in elastic image and gray-scale image were 1.13±0.19 and 1.95±0.62, respectively (P<0.001). SWV ratio of lesions and surrounding breast tissue at the same level were 2.38±1.29 and 5.82±1.76, respectively (P<0.001). The area under the curve (AUC) of area ratio and SWV ratio on the ROC curves respectively were 0.917 and 0.938, while 95% confidence interval were 86.80%—96.50% and 89.60%—97.90%, respectively. Taking the area ratio 1.43 and SWV ratio 3.69 as optimal cut-off, the accuracy, sensitivity, specificity and positive predictive value was 89.47% (136/152), 76.19% (48/63), 98.88% (88/89), 97.96% (48/49) and 90.13% (137/152), 80.95% (51/63), 96.63% (86/89), 94.44% (51/54), respectively. Conclusion ARFI elastography can effectively improve the accuracy of differentiating benign and malignant BI-RADS-US 4 breast lesions. |
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