声脉冲辐射力成像技术对鉴别良恶性胆囊壁增厚的应用价值

目的：探讨声脉冲辐射力成像技术（coustic radiation force impulse,ARFI）鉴别良恶性胆囊壁增厚的应用价值。方法：使用西门子超声的声脉冲辐射力（ARFI）弹性成像的声触诊组织定量成像（virtual tough tissues quantification ,VTQ ）和声触诊组织定性成像（virtual tough tissues imaging,VTI）检测327 例受检者的胆囊壁,比较取样区胆囊壁的横向剪切波速度即声触诊组织量化值（VTQ ）及VTI 图像特征。结果：正常胆囊壁、良性增厚胆囊壁与壁厚型胆囊癌胆囊壁的VTI 图像有明显差异,VTQ 测值有显著差异（P < 0.05）,根据ROC 曲线分析最佳诊断界值,当剪切波速度≥ 2.65m/s时,诊断胆囊癌的灵敏度、特异度分别为94.0% 、93.7% 。结论：声脉冲辐射力成像技术可以无创鉴别良恶性胆囊壁增厚,具有临床应用价值。     

声脉冲辐射力弹性成像对甲状腺微小癌的诊断价值

目的探讨声脉冲辐射力(ARFI)弹性成像对甲状腺微小癌(TMC)的诊断价值。方法对徐州医学院附属医院2014年7月至2015年7月期间收治的甲状腺小结节患者47例53个最大径≤1 cm结节应用常规超声及ARFI弹性成像进行检查。以病理诊断为金标准,分别绘制VTI与VTQ诊断TMC的ROC曲线,比较曲线下面积。结果 53个结节包括良性病变25个,恶性病变28个。VTI检查硬度分级≥Ⅳ级结节22个,包括良性病变0个,恶性22个;VTI分级Ⅳ级结节31个,包括良性病变25个,恶性6个。VTI诊断TMC的敏感性、特异性、准确率分别为78.6%、100%、88.8%。VTQ检查横向剪切波速度(SWV)≥2.76m/s结节25个,其中7个良性病变,18个恶性病变;SWV2.76 m/s结节28个,其中18个良性病变,10个恶性病变。VTQ诊断TMC的敏感性、特异性、准确率分别为64.3%,72.0%,67.9%。VTI及VTQ诊断TMC的ROC曲线下面积(AUC)分别为0.898和0.672(Z=2.317,P=0.0351)。结论 ARFI弹性成像鉴别诊断TMC效果良好,其中VTI较VTQ具有更高的诊断价值。     

声触诊组织成像定量技术联合超声造影对BI-RADS 4类乳腺肿瘤的鉴别诊断价值

目的 探讨声触诊组织成像定量技术(virtual touch tissue imaging quantification,VTIQ)联合超声造影(contrast-enhanced ultrasound,CEUS)对乳腺影像报告和数据系统(Breast Imaging Reporting and Data System...     

ARFI技术在乳腺良恶性结节鉴别诊断中的价值

目的:探讨声脉冲辐射力弹性成像技术（acoustic radiation force impulse,ARFI）对乳腺良恶性结节鉴别诊断的临床应用价值。方法:选取2015年1月至2017年12月在我院诊治，对有明确病理诊断结果的185例乳腺结节患者（199个病灶）的临床诊断资料进行回顾性分析。分别应用VTI、VTQ技术对乳腺结节进行诊断，对比分析诊断结果。结果:VTQ鉴别诊断乳腺良恶性结节正确162个，误诊37个，诊断准确率81%；绘制ROC曲线分析得出AUC为0.86，良、恶性结节最佳截断值为4.6 m/s，此时诊断敏感度82%，特异度84%。 VTI诊断乳腺结节正确149个，误诊50个，诊断准确率75%；进行ROC曲线分析，AUC为0.76，以VTI分级≥IV级作为乳腺良恶性结节的鉴别诊断点，其敏感度78%，特异度74%。结论:声脉冲辐射力弹性成像技术为乳腺良、恶性结节的鉴别诊断提供了一种新的诊断方法，具有很高的临床应用价值。     

超声造影联合声辐射力脉冲成像在周围型肺占位中的临床应用价值研究

目的 探讨超声造影(Contrast enhanced ultrasonography, CEUS)联合声辐射力脉冲成像(Acoustic radiation force impulse, ARFI)诊断周围型肺占位的临床应用价值。方法 回顾性研究2019年1月—2021年6月在哈尔滨医科大学附属第二医院接受手术或活检病理确诊的51例周围型肺部病变患者,分析他们在常规超声、CEUS和ARFI检查中病灶的相关数据,评估并比较CEUS、ARFI及两者联合应用鉴别良恶性占位的诊断效能。结果 肿块是否为类圆形在常规超声下良恶性组间有统计学差异(P<0.01)。恶性占位在CEUS中的始增时间(Rise time, RT)比良性占位RT更长且达峰时间(Time to peak, TTP)更短(P<0.05)。在ARFI检查中恶性占位的剪切波速度(Shear wave velocity, SWV)明显高于良性占位(P=0.04)。CEUS中占位RT和TTP分别超过10.5 s及19.5 s时诊断为恶性的敏感度为77.4%,特异度为85.0%,准确性72.5%。ARFI检查中占位SWV均值...     

声脉冲辐射力弹性成像技术对甲状腺良恶性结节的鉴别诊断价值

目的   探讨声脉冲辐射力弹性成像技术（ARFI）用于鉴别诊断甲状腺良、恶性结节的临床应用价值。方法  选取2015年6月至2016年9月在河南科技大学第一附属医院拟行甲状腺结节切除手术的68例患者（共99个结节）,对其影像学资料进行回顾性分析。患者术前行ARFI检查,观察并记录ARFI技术剪切波的速度（SWV）值,分析良性和恶性结节、病变结节同周边无病变组织间SWV值的差异。采用受试者工作特征曲线（ROC）获取鉴别甲状腺良、恶性结节SWV值的截断值,以病理组织学诊断结果 作为金标准,分析ARFI技术对诊断良、恶性结节性甲状腺病灶的灵敏度、特异度、准确率、阳性预测值及阴性预测值。结果 甲状腺良性、恶性结节及周边正常甲状腺组织的SWV平均值分别为（2.68±0.51）m／s、（3.09±0.53）m／s和 （2.42±0.22）m／s,恶性结节的SWV值高于良性结节,差异有统计学意义（P＜0.001）,甲状腺良、恶性结节SWV值均高于周边正常组织,差异有统计学意义（P＜0.001）。甲状腺良性结节和恶性结节与周围组织的SWV比值分别为（1.108±0.205）、（1.277±0.258）,差异有统计学意义（P＜0.001）。SWV值诊断甲状腺病灶良、恶性的灵敏度、特异度、准确率、阳性预测值及阴性预测值分别为63.41％、74.14％、69.70％、63.41％和74.14％。SWV比值诊断良、恶性甲状腺结节的灵敏度、特异度、准确率、阳性预测值及阴性预测值分别为58.54％、79.31％、69.70％、64.86％和72.58％。结论 ARFI技术作为一项无创技术用于鉴别结节性甲状腺病灶的良、恶性有很高的临床应用价值,能够被广泛应用于临床初步鉴别结节性甲状腺病灶。     

声触诊组织量化成像技术对乳腺BI-RADS 4类病变的诊断价值

摘 要：［目的］ 评估声触诊组织量化成像(vitual touch imaging quantification,VTIQ)对BI-RADS 4类乳腺病变的诊断价值。［方法］ 分析150例BI-RADS 4类乳腺病变的VTIQ值,以病理结果为标准,绘制ROC曲线,确定良恶性诊断的VTIQ最佳阈值,校正BI-RADS分类,分析VTIQ校正前后诊断率有无统计学差异。 ［结果］ 150个病变中良性76个,恶性74个。BI-RADS分类诊断乳腺病变良恶性ROC曲线下面积为0.807,敏感度、特异性、准确率、阳性预测值和阴性预测值分别为81.58%（62/76）、74.32%（55/74）、78.0%（138/150）、76.54%（62/81）和79.71%（55/69）。乳腺恶性病变的SWV值明显高于良性病变(P<0.001),诊断良恶性的最佳阈值SWV为4.09m/s,校正后ROC的曲线下面积为0.884,敏感度、特异性、准确率、阳性预测值和阴性预测值分别为90.79%(69/76)、90.79%(69/74)、92%(138/150)、93.24%(69/74)和90.79%(69/76)。［结论］ VTIQ有助于诊断BI-RADS 4类乳腺病变,优化穿刺适应证的选择。     

超声造影和声辐射力脉冲技术在肾良恶性肿瘤鉴别诊断中的价值比较

目的 探讨超声造影和声辐射力脉冲技术在鉴别诊断肾实质良恶性病灶中的应用价值。方法对67例疑似肾肿瘤患者进行超声造影（CEUS）和声辐射力脉冲（ARFI）技术检查,所有检查结果均经手术后病理证实或随访观察证实,采用双盲法分析两种超声技术对肾脏良恶性肿瘤的诊断价值。结果 CEUS诊断肾良、恶性肿瘤的敏感度、特异性、准确率分别为89.80%、88.89%、89.55%;ARFI技术诊断的敏感度、特异性、准确率分别为81.63%、83.33%、82.09%;两者的诊断效能（敏感度、特异性、准确率）差异无统计学意义（均P>0.05）。结论 CEUS与ARFI技术在诊断肾脏肿瘤的良恶性方面,具有相似的敏感度和准确率,两者对肾脏肿瘤的诊断可起到互补作用,为临床正确诊治疾病提供参考。     

声触诊组织量化技术诊断乳腺纤维腺瘤的临床观察

目的 探讨声触诊组织量化（VTQ）技术对乳腺纤维腺瘤的诊断价值。方法 166例经手术病理组织学证实的乳腺纤维腺瘤患者,共 198个结节,术前均行常规超声及VTQ检查,观察乳腺纤维腺瘤的VTQ特征,记录有数值结节的VTQ值,以平均剪切波速度（Vm）绘制ROC曲线,寻找判断指标。结果 在198个结节中,有25个结节VTQ值缺失,用有效结节的Vm绘制ROC曲线,其曲线下面积＞0.80,以2.25 m／s为临界点判定乳腺纤维腺瘤的敏感度、特异度和准确性分别为86.1％、70.2％和86.3％;乳腺纤维腺瘤内血流信号对其VTQ值有一定的影响,无血流信号肿块的VTQ值大于有血流信号的肿块（P＜0.01）; 乳腺纤维腺瘤的VTQ值在感兴趣区不同深度与不同直径间的差异均无统计学意义（P＞0.05）。结论 VTQ技术对乳腺纤维腺瘤的诊断具有重要价值。     

声辐射力弹性成像联合灰阶超声在甲状腺滤泡型肿瘤中的诊断价值

目的 探讨声辐射力弹性成像联合灰阶超声在甲状腺滤泡型肿瘤中的诊断价值.方法 选取110例甲状腺滤泡型肿瘤患者,分别应用灰阶超声检查、声辐射力弹性成像单独检查及两者联合检查,比较两者单独检查和联合检查的诊断效能.结果 声辐射力弹性成像评分以2～5分为主(92.73％),灰阶超声评分以0～4分为主(89.09％).声辐射力...     

声辐射脉冲成像技术鉴别肝脏肿瘤良恶性的临床研究

 目的　探讨声辐射脉冲成像（ARFI）技术检测肝脏肿瘤组织硬度、评价肿瘤性质的临床价值。方法　对91例肝肿瘤患者的103个病灶进行ARFI检测,其中良性肿瘤55个,恶性肿瘤48个,所有病灶均进行声触诊组织成像（VTI）及声触诊组织定量（VTQ）检测及分析,比较良恶性肿瘤VTI图像特征及VTQ值差异,分析受试者工作特征曲线（ROC）的最佳临界值。结果　VTI图像上,硬度高于周围肝组织的恶性肿瘤占79.17 %（38／48）,良性肿瘤占56.36 %（31／55）,两者差异有统计学意义（χ2＝0.627,P＜0.01）。良性肿瘤VTQ值为（1.72±0.39）m／s,恶性肿瘤VTQ值为（2.64±0.65）m／s,两者比较差异有统计学意义（t＝8.638,P＜0.01）。以2.10 m／s为VTQ截断值,诊断ROC曲线上最佳临界点,其诊断肝脏恶性肿瘤的敏感度、特异度分别为83.3 %、81.8 %。结论　ARFI弹性成像技术提供的组织硬度信息有助于良恶性肝脏肿瘤的鉴别诊断,有望成为未来新的成像模式。     

声辐射力脉冲超声弹性成像对乳腺实质性病灶的诊断(英文)

Objective:The aim of our study was to make the qualitative and quantitative analysis to breast lesions using acoustic radiation force impulses (ARFI), and assess the diagnostic value of ARFI for differentiation between benign and malignant solid breast masses, meanwhile evaluate the influences of ARFI with breast imaging reporting and data system (BI-RADS) of suspicious masses. Methods:Seventy-five women with 86 breast lesions underwent conventional breast ultrasound examination. Then B-mode BI-RADS features and assessments were recorded and standard breast US supplemented by ARFI elastographic examination were repeated. The data were recorded and analyzed as following:area ratio of breast lesion, the shear-wave velocity, the ratio of the shear-wave velocity between lesions and surrounding normal tissues, and according to the elastographic data reconsidered the BI-RADS category, all the results have been correlated with pathological results and make statistical evaluations of ARFI for differentiation between benign and malignant solid breast masses. Meantime our study has correlated the adjusted BI-RADS category of suspicious breast lesions with the pathological results and made assessment. Results:Thirty-eight patients were malignant breast carcinoma (31 invasive ductal carcinoma, 5 intraductal carcinoma in situ, 2 medullary carcinoma, 2 invasive lobular carcinoma), 48 patients were benign breast lesions (23 fibroadenoma, 12 benign nodular hyperplasia, 5 phyllodes tumor, 6 adenosis, 2 intraductal papilloma). Underwent conventional breast ultrasound exam, 42 cases were BI-RADS category 3, 23 cases were BI-RADS category 4. When adding elastographic data, 46 cases were BI-RADS category 3 and 20 cases were BI-RADS category 4. Compared with pathological results showed for both the specificity of BIRADS features and the area under ROC curve has risen. Virtual touch tissue imaging (VTI) and virtual touch tissue quantification (VTQ) data showed the area ratio (AR) between elastographic lesions area and B-mode lesions area, SWV (maximal shear-wave velocity of lesions), R-SWV (shear-wave velocity ratio between lesions and surrounding normal tissues) in benign breast lesions were lower than those in malignant lesions which has statistical significance and the cut-off point were 1.1, 4.65 m/s, 5.18 respectively. Conclusion:The ARFI elastography can provide the reliable qualitative and quantitative analysis about hardness of breast lesions, supply the new BI-RADS category features to suspicious breast masses and serve as an effective diagnostic tool for differentiation between benign and malignant solid masses.     

Differentiation of benign and malignant breast lesions by mechanical imaging

Mechanical imaging yields tissue elasticity map and provides quantitative characterization of a detected pathology. The changes in the surface stress patterns as a function of applied load provide information about the elastic composition and geometry of the underlying tissue structures. The objective of this study is the clinical evaluation of breast mechanical imager for breast lesion characterization and differentiation between benign and malignant lesions. The breast mechanical imager includes a probe with pressure sensor array, an electronic unit providing data acquisition from the pressure sensors and communication with a touch-screen laptop computer. We have developed an examination procedure and algorithms to provide assessment of breast lesion features such as hardness related parameters, mobility, and shape. A statistical Bayesian classifier was constructed to distinguish between benign and malignant lesions by utilizing all the listed features as the input. Clinical results for 179 cases, collected at four different clinical sites, have demonstrated that the breast mechanical imager provides a reliable image formation of breast tissue abnormalities and calculation of lesion features. Malignant breast lesions (histologically confirmed) demonstrated increased hardness and strain hardening as well as decreased mobility and longer boundary length in comparison with benign lesions. Statistical analysis of differentiation capability for 147 benign and 32 malignant lesions revealed an average sensitivity of 91.4% and specificity of 86.8% with a standard deviation of ±6.1%. The area under the receiver operating characteristic curve characterizing benign and malignant lesion discrimination is 86.1% with the confidence interval ranging from 80.3 to 90.9%, with a significance level of P = 0.0001 (area = 50%). The multisite clinical study demonstrated the capability of mechanical imaging for characterization and differentiation of benign and malignant breast lesions. We hypothesize that the breast mechanical imager has the potential to be used as a cost effective device for cancer diagnostics that could reduce the benign biopsy rate, serve as an adjunct to mammography and to be utilized as a screening device for breast cancer detection.     

声脉冲辐射力成像技术评价乳腺癌新辅助化疗疗效的价值研究

目的 探讨声脉冲辐射力成像技术(ARFI)在乳腺癌新辅助化疗疗效评价中的应用价值.方法 选取42例原发性浸润性乳腺癌患者(共42个病灶),所有患者均于新辅助化疗后行外科手术治疗.应用ARFI技术测量新辅助化疗前后病灶最大弹性值变化率.以Millen-Payne(MP)分级系统作为病理反应的评价依据,Ⅰ~Ⅲ级为组织学非显著反应,Ⅳ~Ⅴ级为组织学显著反应.以手术病理诊断为金标准,应用受试者工作特征曲线(ROC)评价ARFI的诊断价值.结果 42例乳腺癌组织中,69.05%(29/42)为组织学显著反应,30.95%(13/42)为组织学非显著反应.通过ROC曲线确定的评价新辅助化疗有效和无效的VTQ值变化率诊断界值为29%(曲线下面积为0.925,95%CI:0.863~0.987),敏感度为91.1%,特异度为83.3%,准确度为87.7%.新辅助化疗后,组织学显著反应组乳腺癌患者的VTQ值(弹性值)明显低于化疗前,差异有统计学意义(P﹤0.01).结论 ARFI技术可通过定量测量新辅助化疗前后乳腺癌硬度变化,为乳腺癌新辅助化疗的疗效评估提供新方向.     

Angiogenesis and dynamic MR imaging gadolinium enhancement of malignant and benign breast lesions

Purpose. To determine whether dynamic magnetic resonance (MR) imagingenhancement parameters are associated with vessel density of malignant andbenign breast lesions. Materials and methods. Forty-five patients with 48breast lesions underwent gadolinium-enhanced spoiled gradient-recalled echo(SPGR) MR imaging followed by excisional biopsy and Factor VIII staining andvessel density measurement in the lesions. Results. The vessel densitieswere not significantly different in 25 malignant breast lesions as comparedto 23 benign breast lesions. Among all 48 lesions, greater MR enhancementshowed an association with increased vessel density. Seventy-four percent ofall lesions with MRI enhancement amplitude greater or equal to three timespost-precontrast ratio had vessel densities greater than the median of 172as compared to 34% of lesions with enhancement amplitude less thanthree times, p = 0.02. The rate and washout of MR enhancement showedno significant association with vessel density. Conclusion. Although thereis an overall significant association between greater MRI enhancementamplitude and vessel density, MRI gadolinium enhancement of breast lesionsis not an accurate predictor of vessel density.     

多参数磁共振成像对乳腺良恶性病变的诊断价值

目的 探讨扩散加权成像(DWI)、T2加权成像(T2WI)和动态对比增强(DCE)-MRI对乳腺癌的诊断价值.方法 对136例患者的169个乳腺病变进行分析,所有患者同时接受了DCE-MRI和DWI(b值为1000 s/mm2)检查.按检查方法分为三组,第一组DCE-MRI,第二组DWI-T2WI,第三组DCE-MRI...     

Nuclear morphometry of benign and malignant breast lesions

The mean nuclear area (MNA) of mammary gland epithelium was measured in 403 breast specimens, comprising 239 invasive carcinomas, 49 carcinomas in situ, 45 cases of fibrocystic disease (f.c.d.) with intraductal epithelial hyperplasia, and 60 cases of f.c.d. without intraductal hyperplasia. Normal breast tissue adjacent to other benign or malignant lesions was measured in 170 specimens. Statistical analysis revealed no difference between the MNA of invasive ductal carcinoma and ductal carcinoma in situ. The MNA of lobular and ductal carcinomas were significantly different. Significant differences were also found between ductal carcinoma and the two classes of f.c.d. The MNA of f.c.d. with and without intraductal hyperplasia were also significantly different, the former having the highest MNA. All breast lesions showed MNA significantly higher than that of normal breast epithelium. These findings show that there is a gradual increase in MNA from the baseline value of normal breast epithelium, via fibrocystic disease without and with intraductal proliferation to invasive carcinomas. Measurement of MNA may aid in pinpointing cases of intraductal epithelial hyperplasia with malignant potential.