声脉冲辐射力成像技术无创检测慢性肝纤维化的初步研究

目的探讨声脉冲辐射力成像技术（ARFI）检测慢性肝纤维化的价值。方法使用西门子超声的声脉冲辐射力成像技术检测320例受检者肝脏右叶,包括无肝病或脂肪肝的志愿者173例、乙肝病毒阳性而病理显示无肝硬化的患者84例和乙肝后病理证实肝硬化的患者63例,比较三组受检者的肝右叶感兴趣区的横向弹性参数值。结果 三组受检者的肝右叶感兴趣区弹性参数有显著差异（p〈0．001）,随着慢性肝病程度的加重,弹性参数值增加,两者有一定相关性。结论声脉冲辐射力成像技术可无创反映肝组织的弹性硬度,间接评估肝纤维化,具有潜在的临床应用价值.     

声辐射力脉冲成像技术检测腮腺及颌下腺局灶性病变的初步研究

目的 应用声辐射力脉冲成像(acoustic radiation force impulse,ARFI)技术定量评价腮腺及颌下腺局灶性病变软硬度,探讨该技术在腮腺及颌下腺局灶性病变鉴别诊断中的临床应用价值.方法 采用ARFI技术分别对34例正常对照组(34个颌下腺)、16例炎性组(16个病灶)、18例(18个病灶)良性病变组、11例(11个病灶)恶性病变组患者进行检查,结合病理结果对各组间剪切波速进行对比分析.结果 正常对照组与炎性组、良性病变组、恶性病变组剪切波速比较差异有统计学意义(P＜0.05),炎性组、良性病变组与恶性病变组剪切波速比较差异有统计学意义(P＜0.05),炎性组患者与良性病变组患者剪切波速比较差异无统计学意义(P＞0.05).结论 ARFI技术可以定量、直观显示正常组织或病变组织的硬度,为腮腺及颌下腺局灶性病变的鉴别诊断提供有价值的信息.     

声辐射力脉冲成像技术在甲状腺占位性病变中的研究

目的:探讨声辐射力脉冲成像技术(ARFI)对甲状腺占位性良恶性病变鉴别诊断的临床价值.方法:应用ARFI技术对75例(共93个病灶)甲状腺占位性病变患者进行检查,所有病例分为恶性占位组、良性占位组,与术后病理结果对照,并分别与正常甲状腺组织剪切波速进行对比分析.结果:ARFI技术检测的甲状腺恶性占位病变与甲状腺良性占位病变组比较,剪切波速差异有显著性意义(P＜0.001);甲状腺恶性占位病变组与甲状腺正常组剪切波速比较差异有极显著性(P＜0.001);甲状腺良性占位与甲状腺正常组剪切波速比较差异具有显著性(P＜0.017).以＞3.0 m/s作为甲状腺恶性占位的诊断标准,ARFI鉴别甲状腺良恶性占位的敏感性为92.1％,特异性为85.5％,约登指数为0.78.结论:ARFI技术可以直观地显示甲状腺肿瘤的硬度,有效评价肿瘤组织的弹性变化,为甲状腺脏良、恶性病变的早期鉴别诊断提供更多的信息和依据.     

声辐射力脉冲成像技术在乳腺占位性病变中的研究

目的探讨声辐射力脉冲成像技术(ARFI)在乳腺占位性良恶性病变鉴别诊断中的临床应用价值。方法选取72例(92个病灶)乳腺占位性病变患者和33例乳腺超声检查正常者(正常对照组),先行乳腺常规超声检查,然后使用ARFI技术检测剪切波速度(SWV),测值与术后病理结果对照,并与正常对照组对比分析。结果最终实际分析病灶数共90个,其中恶性病灶38个,SWV为(7.16±0.57)m/s,良性病灶52个,SWV为(2.71±0.74)m/s,正常对照组SWV为(1.91±0.52)m/s,两两比较差异均有统计学意义(P﹤0.05)。以SWV﹥6.2m/s作为乳腺恶性病变的诊断标准,ARFI鉴别乳腺良恶性占位病变的敏感性为91.7%,特异性为86.2%,约登指数为0.78。结论 ARFI技术可为乳腺占位性良恶性病变的早期鉴别诊断提供更多信息和依据,有重要临床应用价值。     

声辐射力脉冲成像技术对肝占位性病变的诊断价值

目的 探讨声辐射力脉冲成像技术(ARFI)对肝占位性病变良、恶性鉴别诊断的临床价值.方法 采用灰阶超声和ARFI技术对63例肝肿瘤患者(共80个病灶)进行检查,对所有病灶的硬度进行半定量分析,并将其与病理结果对照分析,计算超声弹性成像诊断肝脏恶性肿瘤的敏感性、特异性及准确性.结果 恶性结节超声弹性图像评分明显高于良性结节,差异有统计学意义(P＜0.01).以弹性评分≥3分为诊断界点,诊断为良性病变者39个,恶性病变者41个,误诊7个,诊断敏感性、特异性及准确性分别为83.89％、80.00％和91.18％.结论 ARFI技术可识别肝占位性病变和正常组织间的弹性差异,对肝占位性病变良恶性有一定的诊断价值.     

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。     

声辐射力脉冲技术鉴别诊断甲状腺良恶性结节

目的 探讨声辐射力脉冲（ARFI）技术鉴别甲状腺良恶性结节的价值。方法 对106例甲状腺结节患者于术前行ARFI检查,根据术后病理结果,分析甲状腺良恶性结节ARFI表现及ARFI对甲状腺良恶性结节的鉴别诊断价值。结果 甲状腺恶性结节声触诊组织成像（VTI）分级高于良性结节（Z=8.65,P<0.05）;以VTI≥4级作为恶性结节的标准,诊断敏感度、特异度分别为79.40%、96.80%。甲状腺良恶性结节的声触诊组织量化（VTQ）值差异有统计学意义（t=4.25,P<0.05）;以VTQ≥2.50m/s作为良恶性结节诊断点,其敏感度、特异度分别为75.00%、70.00%。联合应用VTI和VTQ,ARFI对甲状腺良恶性结节的诊断敏感度、特异度分别为95.24%、87.71%。结论 ARFI有助于鉴别诊断甲状腺良恶性结节。     

声辐射力脉冲成像技术在肝纤维化评估中的初步应用

目的探讨声辐射力脉冲(acoustic radiation force impulse,ARFI)成像技术初步应用于肝纤维化评估的价值。方法使用ARFI成像技术检测50例正常受检者、50例非酒精性单纯性脂肪肝患者及18例经病理证实的肝纤维化患者,比较3组的弹性测值。结果 3组受检者弹性测值间差异有统计学意义(P<0.001)。结论 ARFI成像技术对于评估肝纤维化具有临床应用价值。     

声辐射力脉冲成像技术鉴别诊断肾脏肿瘤

目的 评价声辐射力脉冲弹性成像（ARFI）技术诊断肾肿瘤的价值。方法 对86例肾肿瘤患者的86个病灶行常规超声及ARFI检查,比较肿瘤和周围肾实质、良恶性肾肿瘤的剪切波速度（SWV）、声触诊组织成像（VTI）评分的差异。结果 86例肾肿瘤患者中,良性肿瘤32例,均为血管平滑肌脂肪瘤;恶性肿瘤54例,包括肾透明细胞癌26例,肾嫌色细胞癌8例,肾乳头状细胞癌5例,浸润性尿路上皮癌15例;病灶与周围肾实质间SWV、VTI评分的差异均有统计学意义（P均<0.05）,肾良性肿瘤的SWV及VTI评分低于肾恶性肿瘤（P均<0.05）。以SWV > 1.37 m/s或VTI评分 > 3.83判定良恶性肾肿瘤的曲线下面积分别为0.898、0.847（P均<0.05）,敏感度分别为88.9%、83.3%,特异度分别为84.4%、78.1%;肾恶性肿瘤中,ccRCC的SWV及VTI评分明显高于其他恶性肿瘤,以SWV > 2.06 m/s或VTI评分 > 4.31鉴别ccRCC与肾其他肾恶性肿瘤的ROC曲线下面积分别为0.766、0.729（P均<0.05）,敏感度分别为65.4%、57.7%,特异度分别为82.1%、78.6%。结论 ARFI技术在肾良恶性肿瘤的鉴别诊断中具有一定价值,并有助于区分ccRCC与其他肾恶性肿瘤。     

声辐射力脉冲成像技术对乳腺肿块鉴别诊断价值的初步研究

目的 利用声辐射力脉冲成像技术(ARFI)测量剪切波速度(SWV)的方法定量评价正常乳腺组织及乳腺肿块的硬度,分析其对乳腺良、恶性肿块鉴别诊断的临床价值.方法 利用常规超声和ARFI技术对101例患者的正常乳腺组织及146枚肿块进行检查,测量正常乳腺组织及乳腺肿块的SWV值.对结果进行对比分析,鉴别诊断肿块良、恶性.结果 正常乳腺腺体组织的SWV值为(1.63±0.47) m/s,乳腺良性肿块的SWV值为(2.38±0.55) m/s,恶性肿块的SWV值为(7.34±1.76) m/s.正常乳腺组织、乳腺良性肿块及恶性肿块SWV值之间的差异有统计学意义(P＜0.05).以实性肿块中央部位SWV值为xxx m/s为诊断乳腺恶性肿瘤的标准,ARFI诊断乳腺恶性肿瘤的敏感性、特异性、准确度及阳性预测值分别为90.0％、100％、97.9％、100％.该标准结合BIRADS分类,诊断乳腺恶性肿瘤的敏感性、特异性、准确度及阳性预测值分别为100％、97.4％、98.6％、90.9％.结论 ARFI技术可定量评价组织硬度,结合常规超声检查可提高乳腺恶性肿瘤诊断的敏感度和准确度.     

Clinical Utility of Qualitative Elastography Using Acoustic Radiation Force Impulse for Differentiating Benign from Malignant Salivary Gland Tumors

The goal of the work described here was to evaluate the utility of acoustic radiation force impulse (ARFI) imaging, a novel elastography technique, for differentiating benign from malignant salivary gland tumors. With the use of conventional strain elastography (SE) and ARFI imaging with a four-pattern scoring system, 185 tumors were examined (163 benign/22 malignant). When a score of ≥3 was used to define malignancy, the sensitivity, specificity and accuracy were higher for ARFI imaging (77.3%, 63.8% and 65.4%, respectively) than for conventional SE (54.5%, 56.4% and 56.2%, respectively). ARFI imaging findings revealed that most (92%) Warthin tumors, but only 24% of pleomorphic adenomas, were benign (score: 1 or 2). Attenuation of acoustic push pulses made it difficult to determine the stiffness of malignant tumors in the deep parotid lobes. Thus, ARFI imaging is a useful tool for screening Warthin tumors and exhibits high sensitivity for malignant tumors of salivary glands, other than deep parotid lobe tumors.     

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.     

Diagnostic Performance of Acoustic Radiation Force Impulse Elastography for the Differentiation of Benign and Malignant Superficial Lymph Nodes: A Meta-analysis

To estimate the diagnostic performance of acoustic radiation force impulse elastography in distinguishing between benign and malignant superficial lymph nodes, relevant articles published before October 31, 2018, in China and other countries were used. Conclusively, a total of 18 articles were analyzed. Sixteen studies used Virtual Touch tissue quantification (Siemens Healthineers, Erlangen, Germany), and 4 studies used Virtual Touch tissue imaging (Siemens Healthineers). After a meta-analysis, it was found that acoustic radiation force impulse elastography is an efficient method for detecting superficial lymph nodes. In addition, if the cutoff value for the shear wave velocity were less than 2.85 m/s, the summary sensitivity would increase, and the heterogeneity would be reduced.     

肝脏良恶性肿瘤超声造影反向脉冲谐波显像的对比研究

目的 探讨肝肿瘤超声造影反向脉冲谐波（PIH）显像的灌注过程及回声变化，评价其诊断价值。 方法 对94例肝肿瘤进行超声造影PIH显像，比较病灶增强的时相变化特点及灌注特征。 结果 恶性组与良性组开始增强时间、达峰值时间及持续总时间比较均有显著性差异（P〈0．05）；原发性肝癌和肝转移癌持续总时间比较有显著性差异（P〈0．05）。 结论 超声造影PIH可清晰地显示肝肿瘤的动态灌注过程，显著提高了肝肿瘤的诊断水平。     

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.     

经直肠ARFI技术在前列腺病变中的研究

目的 探讨经直肠声辐射力脉冲成像技术(ARFI)对前列腺良恶性病变诊断的临床价值。方法 应用ARFI技术对72例前列腺占位性病变患者进行检查,测值与术后病理结果对照,鉴别其良恶性。结果 ARFI技术检测的前列腺恶性占位病变与前列腺良性占位病变组比较,剪切波速差异有显著性意义(P＜0.05);前列腺良性占位与前列腺正常组剪切波速比较差异具有显著性（P＜0.05）。以剪切波速大于2.94m/s作为前列腺恶性占位的诊断标准,ARFI诊断前列腺良恶性占位的敏感性为86.7%,特异性为66.7%。结论 ARFI技术可以做为前列腺病变早期诊断的一种重要手段。