Solid Hypo-echoic Thyroid Nodules on Ultrasound: The Diagnostic Value of Acoustic Radiation Force Impulse Elastography

The aim of the study described here was to evaluate the diagnostic performance of acoustic radiation force impulse (ARFI) elastography in the differential diagnosis between benign and malignant solid hypo-echoic thyroid nodules (SHTNs) on ultrasound. In this retrospective study, 183 histologically proven SHTNs in 159 patients were enrolled. Conventional US, as well as Virtual Touch tissue imaging (VTI) and Virtual Touch tissue quantification (VTQ) of ARFI elastography, was performed on each nodule. The VTI features of SHTNs were divided into six grades, where higher grades represent harder tissue. VTQ was expressed as shear wave velocity, where higher shear wave velocity values indicate stiffer tissue. The sensitivity, specificity, accuracy, positive predictive value, negative predictive value and Youden index for ultrasound and ARFI were assessed. The 183 pathologically proven SHTNs included 117 benign and 66 malignant lesions. Nodules classified as VTI grades IV to VI were more frequently malignant (49/66, 74.2%) than benign (10/117, 8.5%) (p < 0.001). The mean shear wave velocity of VTQ for malignant SHTNs (mean ± standard deviation, 4.65 ± 2.68 m/s; range, 1.36–9 m/s) was significantly higher than that for benign SHTNs (2.34 ± 0.85 m/s, 0–5.7 m/s) (p < 0.001). The sensitivity, specificity, accuracy, positive predictive value, negative predictive value and Youden index were 27.3%–84.8%, 13.7%–89.7%, 39.3%–69.4%, 35.7%–60%, 61.5%–78.5%, and –0.015 to 0.37 for ultrasound; 68.2%, 76.9%, 73.8%, 62.5%, 81.1% and 0.451 for VTQ; and 74.2%, 91.5%, 85.2%, 83.1%, 86.3% and 0.657 for VTI, respectively. ARFI elastography performed at a superior level, compared with conventional ultrasound, in the differential diagnosis between malignant and benign SHTNs. The diagnostic performance of VTI is higher than that of VTQ.     

Acoustic Radiation Force Impulse Elastography in the Diagnosis of Thyroid Nodules: Useful or Not Useful?

The goal of this study is to evaluate the diagnostic performance of acoustic radiation force impulse (ARFI) elastography for differentiating benign from malignant thyroid nodules. One hundred and seventy-four pathologically proven thyroid nodules (139 benign, 35 malignant) in 154 patients (mean age: 49.2 ± 12.1 y; range: 16–72 y) were included in this study. Conventional ultrasound (US) and ARFI elastography using virtual touch tissue imaging (VTI) and virtual touch tissue quantification (VTQ) were performed to examine the thyroid nodules. Two blinded readers with different amounts of experience independently scored the likelihood of malignancy on the basis of a five-point scale in three different image-reading sets. The diagnostic performances among different image-reading sets and between the two readers were compared. The diagnostic specificity of both readers improved significantly after reading the VTI images or both VTI and VTQ images (all p < 0.05). After review of the results of both VTI and VTQ, the numbers of correctly diagnosed nodules increased in nodules <1.0 cm for both readers and in both nodular goiter and papillary thyroid carcinoma for the junior reader (p < 0.05). The nodules with definite diagnoses (i.e., confidence levels including definite benign and definite malignant cases) increased after review of VTI and VTQ images versus conventional US for the senior reader (p < 0.05). In conclusion, adding ARFI elastography improves the specificity in diagnosing malignant thyroid nodules compared with conventional US on its own. ARFI elastography particularly facilitates the specific diagnosis for thyroid nodules smaller than 1.0 cm. ARFI elastography is also able to increase the diagnostic confidence of the readers.     

声脉冲辐射力成像鉴别诊断良、恶性BI-RADS 4级乳腺肿块

目的 评价声脉冲辐射力成像(ARFI)在乳腺影像学报告及数据系统(BI-RADS)4级乳腺肿块良、恶性诊断中的价值。 方法 用ARFI对68例共75个常规超声诊断为BI-RADS 4级的乳腺肿块进行成像,测量声触诊组织成像(VTI)模式下肿块面积与常规二维超声肿块面积比值(AR),并测量声触诊量化成像(VTQ)模式下肿块剪切波速度(SWV);以病理结果(恶性34个,良性41个)为金标准,构建ROC曲线,评价ARFI的2种成像模式对BI-RADS 4级乳腺肿块的诊断价值。 结果 良、恶性BI-RADS 4级乳腺肿块的AR值差异有统计学意义(P<0.05),ROC曲线下面积(AUC)为0.851,敏感度、特异度、准确率分别为82.40%、80.50%、81.30%。良、恶性BI-RADS 4级乳腺肿块的SWV值差异有统计学意义(P<0.05)。SWV值AUC为0.861,敏感度、特异度、准确率分别为85.30%、85.40%、85.30%。二者AUC差异无统计学意义(Z=1.47,P>0.05)。二者联合诊断的敏感度、特异度、准确率分别为88.20%、87.80%、88.00%。 结论 ARFI对鉴别BI-RADS 4级乳腺肿块的良、恶性具有较高价值;联合应用VTI和VTQ可以提高诊断效能。     

声辐射力冲击成像对乳腺结节性质的鉴别诊断价值

目的探讨应用声辐射力冲击成像(ARFI)技术对乳腺良性与恶性结节病灶的鉴别诊断价值。方法以33例<10 mm恶性乳腺结节患者及同期20例良性乳腺结节患者为研究对象,利用ARFI的声触诊组织成像(VTI)定性结节范围和声触诊组织定量(VTQ)量化结节的剪切波速度,与临床病理结果比较,分析良恶性病灶的ARFI-VTI和ARFI-VTQ参数差异。结果 ARFI-VTI能定性病灶结节范围,病灶结节在VTI图中与二维图中的面积比参数在良恶性组间差异有显著统计学意义,恶性组>1,良性组≤1(P<0.01);ARFI-VTQ测值在良恶性结节间差异有显著统计学意义,良性结节组VTQ剪切波速度为(2.67±1.63)m/s,恶性结节组VTQ剪切波速度为(5.24±2.72)m/s(P<0.01);对小结节型乳腺癌的诊断与病理诊断符合率为97.0%,特异度为80.0%。结论 ARFI检查对结节<10 mm的乳腺良恶性肿瘤具有鉴别诊断价值,值得临床应用推广。     

比较声触诊组织量化与弹性应变率比值法诊断乳腺疾病

目的 比较声触诊组织量化(VTQ)与弹性应变率(SR)比值法判断乳腺病变良恶性的价值.方法 对103例女性患者共126个乳腺病变进行压迫式弹性成像检查,获得相应的弹性图,测量SR值;进一步应用声辐射力脉冲成像测量病灶的VTQ值;以病理结果为金标准,构建ROC曲线,比较两种方法的诊断价值.结果 VTQ值判断乳腺病变良恶性的最佳临界点为6.64 m/s,ROC曲线下面积为0.88,其判断乳腺恶性病变的敏感度、特异度和准确率分别为82.61％(19/23)、100％(103/103)和96.83％(122/126).SR比值法判断乳腺恶性病变的ROC曲线下面积为0.87.二者ROC曲线下面积的差异无统计学意义(P＞0.05).结论 VTQ技术可用于判断乳腺良恶性病变,其诊断价值与SR比值法相当.     

声辐射脉冲力技术定量鉴别诊断良恶性乳腺肿块

目的 探讨声辐射脉冲力(ARFI)技术在定量诊断乳腺良恶性肿块中的应用价值.方法 对175例患者227个乳腺肿块进行常规二维、彩色多普勒超声检查,同时采用ARFI技术测量剪切波速度(SWV),取样框分别置于肿块内部、肿块与周围腺体组织交界处以及周围腺体组织,以病理结果为金标准.结果 良性肿块内部及交界处SWV分别为(2.38士0.52)m/s、(2.14±0.61)m/s;恶性肿块内部及交界处SWV分别为(7.62士2.51)m/s、(5.32±2.63)m/s.恶性肿块内部及交界处SWV值均明显高于良性肿块(P均＜0.05);良性肿块内部与交界处SWV值均明显高于周围腺体(P均＜0.05).绘制ROC曲线,以3.29 m/s为分界值,ARFI技术诊断良恶性肿块的敏感度为78.9％,特异度为98.3％,准确率为77.5％,曲线下面积为0.914.结论 ARFI在乳腺良恶性肿块诊断与鉴别诊断中具有重要临床意义.     

声脉冲辐射力弹性成像技术在鉴别诊断甲状腺良、恶性结节中的作用

目的 探究声脉冲辐射力弹性成像技术(ARFI)在鉴别诊断甲状腺良、恶性结节中的作用.方法 选择2018年1月至2020年9月我院经穿刺活检或手术病理证实的甲状腺结节患者67例(82个甲状腺结节),给予常规彩色多普勒超声检查与ARFI技术中的声触诊组织成像技术(VTI)和声触诊组织定量技术(VTQ)检查.比较VTI面积与...     

声脉冲辐射力成像技术鉴别诊断肝脏良恶性局灶性病变

目的探讨声脉冲辐射力成像技术(ARFI)对肝脏良恶性局灶性病变的鉴别诊断价值。方法对64例患者76个肝脏局灶性病变进行ARFI检查并分析,包括声触诊组织成像技术(VTI)和声触诊组织量化技术(VTQ)。所有患者均经手术或穿刺病理证实或两种增强影像学检查(CEUS、CT、MRI)确诊。采用ROC曲线评价剪切波速(SWV)对肝脏局灶性病变良恶性的鉴别诊断价值,并确定临界点。结果 VTI声像图中,31个(31/40,77.50%)恶性病灶和13个(13/36,36.11%)良性病灶呈灰黑色(P<0.05);良性病灶SWV明显低于恶性病灶[(1.67±0.61)m/s vs(2.80±1.07)m/s,P<0.01)。以SWV=2.04m/s为临界点鉴别肝脏局灶性病变的良恶性,其敏感度、特异度和准确率分别是82.50%、80.60%和81.58%。结论 ARFI有助于鉴别诊断肝脏良恶性局灶性病变,具有良好的临床应用前景。     

声触诊组织定量技术在鉴别诊断乳腺良、恶性病灶中的价值

目的 探讨声触诊组织定量(VTQ)技术在乳腺良、恶性病灶鉴别诊断中的应用价值.方法 采用VTQ定量技术对48例共50个病灶进行研究,其中良性病灶31个,恶性病灶19个,所有病例均经手术切除或穿刺组织活检证实.利用ROC曲线对测量结果进行分析,评价VTQ技术的诊断价值并确定诊断界值.结果 良、恶性病灶的VTQ值分别为(2.45±0.49)m/s和(5.87±3.31)m/s,恶性病灶的VTQ值明显大于良性病灶,两者比较差异有统计学意义(t=7.75,P＜0.01),3例恶性病灶的VTQ值＞10.00 m/s(VTQ值显示极限为10.00 m/s).ROC曲线下面积为0.868±0.061,95%的置信区间为0.749～0.986,当诊断界值为3.595时,VTQ的敏感度和特异度分别为73.7%和100.0%.结论 VTQ技术可以客观地反映组织硬度,在乳腺良、恶性病灶的鉴别诊断中具有较好的价值.     

Acoustic Radiation Force Impulse Elastography for Chronic Liver Disease: Comparison with Ultrasound-Based Scores of Experienced Radiologists,Child-Pugh Scores and Liver Function Tests

The purpose of our study was to investigate whether acoustic radiation force impulse (ARFI) elastography provides better diagnostic performance for diagnosis of chronic liver disease and correlates better with Child-Pugh scores and liver function tests, compared with an ultrasound (US) scoring system based on visual assessment of conventional B-mode US images by experienced radiologists. Five hundred and twenty-one patients with clinically proven chronic liver disease (n = 293), fatty liver (n = 95) or normal liver (n = 133) were included in this study. B-mode liver US and ARFI elastography were performed in all patients. ARFI elastography was performed at least five times, with each measurement obtained at a different area of the right hepatic lobe; mean shear wave velocity (SWV) was calculated for each patient. The mean SWV was compared with US-based scores from two radiologists (based on liver surface nodularity, parenchyma echotexture and hepatic vein contour), Child-Pugh scores and liver function tests. The mean SWV of the normal liver group was 1.08 m/s ± 0.15; of the fatty liver group, 1.02 m/s ± 0.16; and of the chronic liver disease group, 1.66 m/s ± 0.60 (p < 0.001). The area under the receiver operating characteristics curve of the mean SWV in ARFI elastography was significantly higher than that of the conventional B-mode US-based scores by two radiologists (0.89 vs. 0.74 and 0.77, p < 0.05), with a sensitivity of 75.4% and a specificity of 89.5% at the cut-off value of 1.22 m/s. The sensitivity of the mean SWV was significantly higher than the US-based scores (p < 0.001), although the specificity was not (p > 0.05). The mean SWV was better correlated with Child-Pugh scores and all liver function tests (except total protein) than the US-based scores from two radiologists. In conclusion, ARFI elastography showed better diagnostic performance than visual assessment of experienced radiologists for diagnosis of chronic liver disease, as well as for evaluation of the severity of chronic liver disease. (E-mail: leejy4u@snu.ac.kr)     

声脉冲辐射力弹性成像检测乳腺良恶性肿块硬度的初步研究

目的应用声脉冲辐射力弹性成像(ARFI)技术评价乳腺肿块硬度,探讨其在鉴别诊断乳腺良、恶性肿块中的价值。方法分析90例共102个经病理证实的乳腺肿块常规超声及ARFI成像特征,记录声触诊组织成像与二维超声图像病灶面积比值(AR)、声触诊组织量化成像检测深度及剪切波速值(SWV)、病灶与周边相同深度正常乳腺组织剪切波速比值(R-SWV),分析乳腺癌与各良性病灶之间的差异。结果获取剪切波速的成功率>94%。乳腺癌较其他各良性病灶的声触诊组织成像显示图像更黑,其次为乳腺炎和乳腺纤维腺瘤。乳腺癌AR、SWV及R-SWV较各良性病灶均明显增高(P<0.01),AR、SWV、R-SWV诊断乳腺癌的cutoff值分别为1.66、6.71m/s、5.02,各良性病灶间比较差异均无统计学意义。结论应用AFRI弹性成像技术能定性、定量反映乳腺肿块的弹性特征,对乳腺癌的诊断具有一定的价值,尤其对于乳腺癌与乳腺炎的鉴别诊断有较大帮助。     

声脉冲辐射力弹性成像在颈部淋巴结良恶性诊断中的价值

目的探讨声脉冲辐射力成像（ARFI）中声触诊组织成像（VTI）与声触诊组织定量（VTQ）技术在颈部淋巴结良恶性鉴别诊断中的应用价值。 方法分析65例100个颈部淋巴结疾病患者的常规超声及ARFI成像特征,测量淋巴结VTI图像与二维图像面积比及其SWV值,以病理学结果作为金标准,绘制ROC曲线,获得区分颈部淋巴结良恶性VTI面积比值及SWV的临界值。 结果5个常规超声评价指标中P < 0.01的有短径/长泾、淋巴门及微钙化,它们在常规超声鉴别颈部淋巴结良恶性的敏感度、特异度及准确度分别为84.81%,90.47%,86%;86.07%,95.23%,88%;0,52.38%,11%。非特异性反应性淋巴结组VTI面积比为1.07±0.26,恶性淋巴结组的VTI面积比为1.68±0.31,两者相比差异具有统计学意义（T=8.9356,P < 0.001）。非特异性反应性淋巴结组的SWV值为1.72±0.89 m/s,恶性淋巴结组的SWV值为2.68±0.48 m/s,二者比较差异具有统计学意义（T=4.7141,P < 0.001）。构建VTI及SWV的ROC曲线后,其AUC分别为0.799和0.862,根据ROC曲线选取鉴别良恶性淋巴结的VTI面积比及SWV值的临界值分别为1.2、1.9,其对应的敏感度、特异度、准确度分别为96.20%,95.23%,96%;89.87%,90.47%,90%。 结论ARFI弹性成像有助于鉴别颈部淋巴结的良恶性。       

Shear-Wave Elastography: Could it be Helpful for the Diagnosis of Non-Mass-Like Breast Lesions?

The goal of this study was to analyze the diagnostic performance of shear wave elastography (SWE) in differentiation of benign and malignant non-mass-like (NML) breast lesions. Three hundred sixteen consecutive breast lesions in 305 patients who have been scheduled for ultrasound (US)-guided core needle biopsy or vacuum-assisted biopsy or surgical excision between January 2013 and August 2013 were initially included in this study. Finally, 63 patients with 67 lesions classified as NML lesions comprised our study population. The features of SWE and its diagnostic performance in NML lesions were analyzed. Among the 67 NML lesions, 33 were malignant and 34 were benign. The maximum elastic modulus, mean elastic modulus, minimum elastic modulus, elastic modulus ratio and stiff rim sign of the malignant lesions were all significantly higher than those of benign lesions (p < 0.05). The combination of conventional US with maximum elastic modulus and stiff rim sign got significantly higher diagnostic specificity and positive predictive value (PPV) than conventional US (p < 0.05 for both). In the benign lesions, 23 (67.6%) unnecessary biopsies could have been eliminated after the combination of conventional US and SWE. SWE could increase diagnostic specificity and positive predictive values of NML breast lesions. The combination of conventional US and SWE could reduce unnecessary benign biopsies of NML lesions.     

Quantification of Acoustic Radiation Force Impulse in Differentiating Between Malignant and Benign Breast Lesions

The aim of this study was to evaluate the use of gray-level quantification (GLQ) in virtual touch tissue imaging (VTI) in the differential diagnosis of breast lesions. GLQ values of 153 lesions (101 benign, 52 malignant) were analyzed with matrix laboratory software (MATLAB, The MathWorks, Natick, MA, USA), with gray levels ranging from 0 (pure black) to 255 (pure white). The diagnostic performance of GLQ was also evaluated using receiver operating characteristic curve analysis. The mean GLQ value for benign lesions (103.27 ± 39.44) differed significantly from that for malignant lesions (44.57 ± 13.61) (p < 0.001). At a cutoff value of 52.31, the sensitivity, specificity, accuracy, positive predictive value and negative predictive value were 86.5%, 93.1%, 90.8%, 86.5% and 93.1%, respectively. In conclusion, we have proposed a method for quantification of gray levels in VTI for the differential diagnosis of breast lesions. Our results indicate that this method has the potential to aid in the classification of benign and malignant breast masses.     

声触诊组织量化和弹性成像技术评价乳腺良、恶性肿瘤

目的探讨声触诊组织量化(VTQ)和弹性成像技术诊断乳腺良、恶性肿瘤的价值。方法对86例乳腺病变患者术前分别进行常规超声、弹性超声及VTQ检查,对各病灶进行弹性成像评分和VTQ速度分组,并与病理结果对照。结果乳腺良、恶性肿瘤弹性超声评分差异有统计学意义(P<0.05),良性肿瘤中弹性超声评分为1～3分者占为68.09%(32/47),恶性肿瘤中弹性超声4～5分者占82.05%(32/39)。乳腺良、恶性肿瘤的VTQ速度值差异亦有统计学意义(P<0.05)。常规超声、弹性超声、VTQ技术联合应用的诊断准确率达91.86%。结论联合应用常规超声、弹性成像、VTQ技术,可显著提高诊断乳腺良、恶性肿瘤的准确率。     

声触诊组织定量技术鉴别诊断甲状腺结节良恶性的应用价值

目的：探讨声脉冲辐射力成像（ARFI）声触诊组织定量（VTQ）技术在甲状腺良、恶性结节鉴别诊断中的应用价值,并进一步探索不同切面对甲状腺VTQ值的影响。方法应用VTQ技术对210例共240枚甲状腺结节进行检测,分别进行横切面和纵切面扫查,记录结节及周边甲状腺组织的横向剪切波速度（SWV）。利用ROC曲线对测量结果进行分析,评价VTQ技术的诊断价值并确定诊断界值,并采用Z检验比较两种方法的诊断效能差异。结果横、纵切面甲状腺良性结节及周边甲状腺组织的SWV平均值分别为（2.34±1.41）m/s、（1.95±0.47）m/s 和（2.41±1.36）m/s、（2.07±0.41）m/s,恶性结节及周边甲状腺组织的SWV平均值分别为（4.97±2.97）m/s、（1.97±0.50）m/s和（5.02±2.94）m/s、（2.09±0.46）m/s。恶性结节的SWV值明显高于良性结节,两者比较差异有统计学意义（P＜0.0001）;恶性结节与其周边甲状腺组织比较,差异有统计学意义（P＜0.0001）;而良性结节与其周边甲状腺组织无明显统计学差异（P＞0.05）。横、纵切面ROC曲线下面积分别为0.840、0.842,以2.61 m/s诊断界值点时,对应的敏感度、特异度分别为70.5%、76.3%,特异度为77.6%、80.6%。结论 VTQ技术可以定量评价不同甲状腺组织的硬度,在鉴别甲状腺良恶性结节方面具有较高的临床应用价值。横、纵扫查切面不是甲状腺结节VTQ弹性成像的影响因素。     

Diagnosis of Thyroid Nodules Using Virtual Touch Tissue Quantification Value and Anteroposterior/Transverse Diameter Ratio

This paper proposes an effective approach to differential diagnosis of thyroid nodules using a hierarchical classification model based on the Virtual Touch tissue quantification (VTQ) value and anteroposterior/transverse diameter (A/T) ratio. One hundred twenty nodules (92 benign, 28 malignant) were analyzed using this approach by combining the quantitative elastic characteristic with the conventional sonographic feature. First, nodules were classified as benign (VTQ values <2.27 m/s), malignant (VTQ values >2.73 m/s) and indeterminate (2.27 m/s ≤ VTQ values ≤2.73 m/s) using two cutoff points selected on the basis of receiver operating characteristic analysis. Second, the indeterminate nodules were separated into malignant and benign nodules using an A/T ratio ≥1. The advantage of this approach was that it could alleviate the limitation of an overlap in VTQ values between benign and malignant nodules. According to the pathologic results, the accuracy of this approach was 95%. The proposed approach may potentially improve diagnostic accuracy.     

二维超声、实时组织弹性成像及声触诊组织量化技术诊断乳腺浸润性导管癌

目的 探讨二维超声(2D-US)、实时组织弹性成像(UE)及声触诊组织量化(VTQ)技术对乳腺浸润性导管癌(IDC)的诊断价值。方法 对188例患者共213个乳腺病灶术前分别行2D-US、UE及VTQ检查,对各病灶2D-US声像图表现进行超声乳腺影像报告数据系统(BI-RADS-US)分类,UE采用5级评分法判断结节性质,VTQ技术定量测定结节内剪切波速度(SWV)。绘制ROC曲线,比较2D-US、UE、SWV曲线下面积(AUC)。结果 2D-US诊断IDC的敏感度为82.35%(126/153),特异度为71.67%(43/60),准确率为79.34%(169/213)。UE诊断IDC的敏感度为86.27%(132/153),特异度为73.33%(44/60),准确率为82.63%(176/213)。良性及恶性结节的SWV别为(3.09±1.26)m/s、(6.83±2.18)m/s(P<0.05);以3.59 m/s作为诊断恶性病灶的最佳截断值,VTQ诊断IDC的敏感度为86.93%(133/153),特异度为76.67%(46/60),准确率为84.04%(179/213)。2D-US、UE、SWV诊断乳腺IDC的AUC分别为0.811、0.843、0.899,差异有统计学意义(P<0.01)。结论 US、UE及VTQ均有助于鉴别诊断乳腺良性结节及乳腺IDC,UE优于2D-US,VTQ可获得客观的量化指标,重复性好,优于UE和2D-US。     

Acoustic Radiation Force Impulse Imaging for Reactive and Malignant/Metastatic Cervical Lymph Nodes

The aim of this study was to compare lymph node stiffness using acoustic radiation force impulse (ARFI) imaging in patients with cervical lymph node swelling. Forty-two cervical lymph nodes (reactive, n = 22; metastatic, n = 20) from 19 patients (13 men, 6 women; mean age, 63.68 ± 14.9 y; range, 23–85 y) were examined between September 2011 and March 2012. The shear wave velocity (SWV, m/s) of each lymph node was evaluated by ARFI imaging. SWV of reactive lymph nodes was 1.52 ± 0.48 m/s, and that of metastatic/malignant lymph nodes was 2.46 ± 0.75 m/s. A SWV > 1.9 m/s was very useful metastatic lymph node classification, with 95.0% specificity, 81.8% sensitivity and 88.0% overall accuracy. The area under the receiver operating characteristic curve was 0.923 (95% confidence interval, 0.842–1.000). ARFI imaging can be useful in the differentiation of reactive and malignant/metastatic cervical lymph nodes.     

声辐射力脉冲成像鉴别诊断肾肿瘤

目的 探讨声辐射力脉冲成像(ARFI)鉴别诊断肾良恶性肿瘤的价值,以及ARFI所示肿瘤硬度与CEUS反映的肿瘤灌注之间的关系。 方法 对经手术或穿刺病理证实的35例肾肿瘤患者依次行ARFI及CEUS检查,运用声触诊组织量化(VTQ)技术测量肿瘤组织的剪切波速度(SWV),采用ROC曲线评价SWV对肾良恶性肿瘤的鉴别诊断价值并确定界值,并将ARFI所示肿瘤硬度与CEUS反映的肿瘤灌注情况进行对比。 结果 35例肾肿瘤患者中,VTQ测量的肾良恶性肿瘤的SWV值分别为(2.25±0.33)m/s和(2.72±0.46)m/s(P<0.05);以SWV=2.355 m/s为界值,鉴别诊断肾良恶性肿瘤的敏感度为83.30%,特异度为72.70%。22例(22/35,62.86%)肾肿瘤SWV值高于肾皮质,其中CEUS表现为高强化19例,低强化3例;13例(13/35,37.14%)肾肿瘤SWV值低于肾皮质,其中CEUS表现为高强化5例,低强化8例。不同硬度的肾肿瘤血流灌注程度不同,质地硬者灌注较高,质地软者灌注较低(P<0.05)。 结论 ARFI技术有助于鉴别良恶性肾肿瘤,其所示肾肿瘤硬度与血流灌注有关。