声触诊组织成像量化技术联合C-TIRADS与K-TIRADS对甲状腺结节的诊断效能比较

目的探讨声触诊组织成像量化(VTIQ)技术联合中国超声甲状腺影像报告系统(C-TIRADS)和韩国甲状腺影像分级系统(K-TIRADS)对甲状腺结节良恶性的诊断效能。 方法回顾性选择160例甲状腺结节患者,按病理结果分为良性组和恶性组。所有患者均经常规超声检查、VTIQ检查,根据C-TIRADS、K-TIRADS分级标准进行分级。ROC曲线分析C-TIRADS、K-TIRADS单独诊断或联合VTIQ对甲状腺结节良恶性的诊断效能。 结果两种系统单独应用时,K-TIRADS灵敏度低于C-TIRADS,但K-TIRADS特异性更高。与C-TIRADS、K-TIRADS比较,K-TIRADS和C-TIRADS联合VTIQ对甲状腺结节的诊断效能均有所增加,C-TIRADS联合VTIQ后特异度和灵敏度高于K-TIRADS联合VTIQ(P＜0.05)。 结论C-TIRADS或K-TIRADS联合VTIQ对甲状腺结节良恶性的诊断效能高于单独诊断,C-TIRADS联合VTIQ更有利于甲状腺良恶性判断。     

Elasticity standard values of the thoracolumbar fascia assessed with acoustic radiation force impulse elastography on healthy volunteers: A cross section study

IntroductionDetermining the normal values for acoustic radiation force impulse (ARFI) shear wave elastography of the thoracolumbar fascia (TLF) and define possible factors of influence.MethodsWe measured the shear wave velocity (SWV) in m/s and the diameter (anterior-posterior) in mm of the TLF bilateral in 267 healthy participants with the Acuson S3000™ (Siemens) using the virtual touch image quantification mode (VTIQ). The parameters were tested for correlations with the anthropometric data of the participants, between different age groups and the genders, as well as information obtained from the history, such as smoking and sporting activities.ResultsWe determined a mean SWV of 3.28 ± 0.55 m/s for the left thoracolumbar fascia and 3.44 ± 0.55 m/s for the right. The diameter on the right was 2.7 ± 0.8 mm. On the left, it was 2.7 ± 0.9 mm. Neither body mass index (BMI) nor gender had a significant effect on either of the measured parameters (p > 0.05). The same goes for regular medication, sporting activity or the consumption of alcohol (p > 0.05). The results concerning the effect of smoking and age were inconclusive as they only had a significant influence to either the right or the left side of the TLF but not on the other side.ConclusionsWe collected the normal value for ARFI shear wave elastography of the TLF in 267 healthy participants. Furthermore, neither gender, BMI, sports activity nor the consumption of alcohol affected the elasticity or the diameter of the thoracolumbar fascia.     

Prediction of pancreatic fistula after pancreatectomy by virtual touch tissue imaging and quantification (VTIQ) technology

ObjectivesThe aim of this study was to quantitatively evaluate the stiffness of pancreatic parenchyma and solid focal pancreatic lesions (FPLs) by virtual touch tissue imaging and quantification (VTIQ) technique and to investigate the potential usefulness of VTIQ method in the prediction of post-operative pancreatic fistula (POPF) after pancreatectomy.MethodsIn this prospective study, patients who scheduled to undergo pancreatectomy were initially enrolled and received VTIQ assessment within one week before surgery. VTIQ elastography (Siemens ACUSON Sequoia, 5C-1 transducer) was used to measure the shear wave velocity (SWV) value of FPLs and the body part pancreatic parenchyma. The palpation stiffness of pancreas was qualitatively evaluated during operation by surgeons. POPF was finally diagnosed and graded through a three-weeks post-operative follow-up according to international study group of pancreatic fistula (ISGPF). SWV values were compared between POPF positive and negative group. Receiver operating characteristic (ROC) analysis was used to evaluate the diagnostic efficacy of SWV value in predicting POPF.ResultsFrom December 2020 to June 2021, 44 patients were finally enrolled in this study, among which, 26 patients were identified to develop POPF after pancreatectomy. The SWV value of pancreatic parenchyma in POPF positive group was significantly lower than that in POPF negative group (P = 0.001). However, there was no significant difference in palpation stiffness between the two groups (P = 0.124). Besides, neither the SWV value of FPL nor the SWV ratio between FPL to surrounding pancreatic parenchyma differ significantly between POPF positive and negative group (P > 0.05). Taking SWV value of pancreatic parenchyma >1.10 m/s as a cut-off value for predicting POPF, area under the receiver operating characteristic curve (AUROC) was 0.864 with 72.2% sensitivity, 92.3% specificity, 86.7% positive predictive value (PPV) and 82.8% negative predictive value (NPV), respectively.ConclusionsVTIQ technique might be a potential non-invasive imaging method to predict POPF before pancreatectomy in future clinical practice.     

常规超声联合声触诊组织量化成像技术对乳腺病变的鉴别诊断价值

目的:探讨常规超声联合声触诊组织量化成像技术(virtual touch tissue imaging quantification,VTIQ)对乳腺良恶性病变的鉴别诊断价值。方法:采用常规超声和VTIQ技术对2019年4月至2019年9月复旦大学附属中山医院厦门医院62例乳腺病灶进行检查,常规超声观察病灶回声、形态、有无点状钙化、穿支血流等特征,并用VTIQ技术测量病灶横向剪切波速度(shear wave velocity,SWV)的最大值SWV_(max)及平均值SWV_(mean),以病理结果为金标准,ROC曲线计算SWV_(max)及SWV_(mean)的截断值,比较常规超声及常规超声结合VITQ的诊断效能。结果:62例病灶中,41例为良性肿瘤,21例为恶性肿瘤。VTIQ的SWV_(max)及SWV_(mean)截断点分别为5.4 m/s和4.2 m/s,SWV_(max)和SWV_(mean)诊断敏感度、特异度分别为72.0%、92.1%和86.0%、79.0%。常规超声和常规超声结合VTIQ诊断敏感度、特异度、Youden指数、阳性预测值、阴性预测值分别为68%、74%、42%、72%、83%和77%、97%、74%、86%、92%,差异具有统计学意义(P0.05)。结论:常规超声联合VTIQ有助于提高乳腺良恶性病变的诊断能力,值得进一步推广。     

乳腺癌不同病理特征患者超声BI-RADS分级、VTIQ技术参数、CA153的差异分析

目的 探究乳腺癌不同病理特征患者超声乳腺影像报告和数据系统(BI-RADS)分级、声触诊组织量化(VTIQ)技术参数和糖类抗原153(CA153)的差异。方法 回顾性分析我院106例经术后病理确诊的乳腺癌患者临床资料,术前均接受常规超声检查进行BI-RADS分级,接受VTIQ技术检查测量病灶剪切波速度(SWV_max),经酶联免疫吸附法检测CA153,分析上述检测结果与临床病理特征的关系。结果 乳腺癌各病理类型、组织学分级、肿瘤大小、病理分子分型间的超声BI-RADS分级分布、CA153水平比较差异均无统计学意义(P>0.05);浸润性小叶癌者SWV_max高于导管内原位癌、浸润性导管癌、其他者,浸润性导管癌、其他者SWV_max高于导管内原位癌,差异有统计学意义(P<0.05);组织学分级3级者SWV_max高于2级、1级者,2级者SWV_max高于1级者,差异有统计学意义(P<0.05);病理分子分型中Luminal B(HER2+)者SWV_max最高,且高于Luminal A、Luminal B(HER2-)、Luminal B(HER2+)、三阴型者,Luminal A者SWV_max最低,且均低于其他分子分型者,差异有统计学意义(P<0.05);乳腺癌淋巴结未转移者BI-RADS分级3~4a级分布多于转移者,SWV_max、CA153水平高于转移者,差异有统计学意义(P<0.05)。结论 超声BI-RADS分级、CA153水平与乳腺癌患者淋巴结转移状态有关,VTIQ技术参数SWVmax与病理类型、组织学分级、肿瘤大小、病理分子分型、淋巴结转移状态均有关,可为乳腺癌临床诊断和病情评估提供有效参考信息。     

Normal breast tissue stiffness measured by a new ultrasound technique: Virtual touch tissue imaging quantification (VTIQ)

Objective

To evaluate normal breast tissue stiffness with virtual touch tissue imaging quantification (VTIQ) using prospectively collected data.

Materials and Methods

B-mode ultrasound and VTIQ were performed in 132 breasts in 97 women. Mean values of VTIQ for parenchyma and fatty tissue were compared between those measured in healthy breasts and in the surrounding of histologically proven benign and malignant breast lesions. Moreover we reviewed VTIQ values according to breast density measured by the American College of Radiology (ACR) categories. In addition we analyzed re-test reliability of VTIQ.

Results

In 132 breasts the mean VTIQ values in parenchyma were significantly higher than in fatty tissue (3.23 m/s ± 0.74 versus 2.5 m/s ± 0.61; p < 0.0001). In healthy breasts as well as in the surrounding of a benign or malignant lesions the VTIQ values of parenchyma were similar (p = 0.12). In fatty tissue, small differences between mean VTIQ values of 2.25 m/s ± 0.51, 2.52 m/s ± 0.48 and 2.65 m/s ± 0.71 (p = 0.01) in the respective groups were observed. The comparison of mean VTIQ values of parenchyma and fatty tissue in more and less dense breasts (ACR 1 + 2 versus ACR 3 + 4 breasts) also yielded no statistically significant difference. The re-test reliability of VTIQ assessed with three independent measurements was moderate (interclass-correlation of 0.52 (p < 0.0001)).

Conclusion

VTIQ is a reliable method for measuring the stiffness of breast tissue. We propose standard values for healthy parenchyma and fatty tissues independent of the surrounding tissue or the ACR category.     

声触诊组织成像和定量技术联合ACR TI-RADS分类对不同直径甲状腺结节的诊断价值

 目的 探讨声触诊组织成像和定量（virtual touch tissue imaging quantification,VTIQ）技术联合美国放射学会（American College of Radiology,ACR）颁布的甲状腺影像报告与数据系统（thyroid imaging-reporting and data system,TI-RADS）对不同直径（diameter,D）甲状腺结节的诊断价值。方法 回顾性分析2018年3月至2020年3月于华东疗养院行甲状腺超声检查并经术后病理证实的122例患者共137个甲状腺结节的常规超声和VTIQ图像资料,所有结节按ACR TI-RADS分类进行评分。结节根据最大直径分为D≤10 mm组和D > 10 mm组。通过Spearman相关性分析评估结节ACR TI-RADS分类与VTIQ技术之间的相关性。利用二元Logistic回归分析生成ACR TI-RADS分类联合VTIQ技术诊断甲状腺结节的恶性预测概率模型,以手术病理为金标准,绘制受试者工作曲线,比较VTIQ技术、ACR TI-RADS分类以及两者联合对甲状腺结节的诊断效能。结果 在评估甲状腺结节良恶性上,VTIQ技术与ACR TI-RADS分类呈中度相关（D > 10 mm组：r=0.656,P < 0.001;D≤10 mm组：r=0.615,P < 0.001）。ACR TI-RADS分类、VTIQ技术和两者联合诊断甲状腺结节的曲线下面积分别为0.828、0.819、0.889（D > 10 mm组）和0.802、0.807、0.827（D≤10 mm组）。结论 VTIQ技术联合ACR TI-RADS分类可提高甲状腺结节的诊断效能,无论是单独应用VTIQ技术、ACRTI-RADS分类,还是两者的联合应用,诊断效能在D > 10 mm组均稍具优势。     

VTIQ在肉芽肿性小叶性乳腺炎与浸润性乳腺癌鉴别诊断中的价值

【摘要】 目的 探讨声触诊组织成像与定量剪切波弹性成像技术(VTIQ)对肉芽肿性小叶性乳腺炎(GIM)与浸润性乳腺癌的鉴别诊断意义。方法 回顾性分析2016年1月1日~2016年12月31日术前常规乳腺影像报告和数据系统（BI RADS）超声诊断为4类,经手术或穿刺活检病理证实为肉芽肿性小叶性乳腺炎的17例患者的VTIQ检查结果,以34例诊断为浸润性乳腺癌患者的VTIQ检查结果作为对照,从病灶质地软硬度上寻找鉴别依据进行良恶性鉴别。结果 17例BI RADS：4类肉芽肿性小叶性乳腺炎剪切波速度（SWV）平均值 （232±062）m/s,浸润性乳腺癌患者SWV平均值（535±157）m/s,ROC曲线截断值为401m/s,低于该值提示病灶为良性可能性大,高于此值提示恶性可能性大。VTIQ检查示乳腺炎病灶较浸润性乳腺癌软,17例患者BI RADS分类从4类降低为3类。结论 VTIQ通过对组织软硬度判断,为肉芽肿性小叶性乳腺炎与浸润性乳腺癌的良恶性鉴别提供了重要依据。     

VTIQ新技术定量检测正常大鼠肾脏实质与集合系统的价值

目的 研究VTIQ新技术在定量检测大鼠肾脏实质与集合系统中的价值。方法 选取40 只正常雄性大鼠,根据体重的不同分为低体重组和高体重组,每组各20只,应用VTIQ新技术测量正常大鼠肾脏实质及集合系统的剪切波速度值（Vs）并进行比较,分析不同侧别和体重对Vs值的影响。结果 不同侧别、体重的正常大鼠肾实质、集合系统同一部位的Vs值差异无统计学意义（P＞0.05）。正常大鼠肾实质与肾集合系统之间的Vs值差异有统计学意义（P＜0.05）。结论 VTIQ新技术可以定量反映正常大鼠肾脏实质与集合系统弹性系数的差异,可为进一步深入研究各种肾脏疾病提供一种全新、无创、定量的检测手段。