BI-RADS分类和声触诊组织成像定量技术对乳腺微小癌的诊断价值

目的 探讨乳腺影像报告和数据分析系统(breast imaging reporting and data system, BI-RADS)、声触诊组织成像定量(virtual touch tissue imaging quantification, VTIQ)技术以及联合应用两种诊断方法对乳腺微小癌的诊断价值。方法 回顾性分析2014年6月至2015年7月同济大学附属第十人民医院诊治的94名女性患者资料,共收集96个经病理证实的乳腺微小结节的BI-RADS分类与VTIQ图像数据,以病理结果为金标准,统计分析BI-RADS分类、结节内部的平均剪切波速度值(shear wave velocity, SWV)以及两者联合应用时对于乳腺微小癌诊断的敏感度、特异度、阳性预测值、阴性预测值和准确率,并对三种诊断方法分别做受试者工作特征曲线(receiver operating characteristic curve, ROC)分析,评价各种方法的诊断效能。结果 病理诊断恶性结节24个(25%),良性结节72个(75%)。BI-RADS分类诊断恶性病灶26个,良性病灶70个,诊断敏感度为70.83%,特异度为87.5%,阳性预测值为65.3%,阴性预测值为90.0%,准确率为83.33%。VTIQ技术诊断恶性病灶27个,良性病灶69个,诊断敏感度为79.16%,特异度为88.89%,阳性预测值为70.37%,阴性预测值为92.75%,准确率为86.45%。两者联合诊断恶性病灶36个、良性病灶60个、诊断敏感度为91.67%,特异度为80.56%,阳性预测值为61.11%,阴性预测值为96.67%,准确率为83.33%。三种诊断方法的ROC曲线下面积(area under ROC curve, AUC)分别为0.785、0.840、0.861。结论 VTIQ技术对乳腺微小癌有很好的诊断价值,联合两种方法可以提高BI-RADS分类对乳腺微小癌的诊断敏感度。

Breast imaging reporting and data system(BI-RADS) and virtual touch tissue imaging quantification(VTIQ) in diagnosis minimal breast carcinoma

Objective To evaluate breast imaging reporting and data system(BI-RADS), virtual touch tissue imaging quantification(VTIQ) and combined application of the two methods in diagnosis of minimal breast carcinoma(MBC). Methods Clinical and imaging data of 94 female patients with 96 pathologically confirmed MBC admitted from June 2014 to July 2015 were retrospective analysis. Using the pathology results as the gold standard, the diagnostic value of BI-RADS, VTIQ and combination of two methods were evaluated, in terms of sensitivity, specificity, positive predictive value(PPV), negative predictive value(NPV) and diagnostic correct rate. The receiver operating characteristic(ROC) analysis was performed and the area under the curve(AUC) was calculated. Results Among 96 MBC lesions, 72(75%)were diagnosed as malignant and 24(25%)were as benign by pathology. As diagnosed by BI-RADS, 26 lesions were malignant and 70 were benign with a diagnostic sensitivity of 70.83%, specificity of 87.5%, PPV of 65.3%, NPV of 90.0% and the correct rate of 83.33%; as diagnosed by VTIQ, 27 lesions were malignant lesions and 69 were benign with a diagnostic sensitivity of 79.16%, specificity of 88.89%, PPV of 70.37%, NPV of 92.75% and the correct rate of 86.45%; as diagnosed by combination of two methods, 36 lesions were malignant and 60 were benign with a diagnostic sensitivity of 91.67%, specificity of 80.56%, PPV of 61.11%, NPV of 96.67% and the correct rate of 83.33%. The AUC of the three diagnostic methods were 0.785,0.840 and 0.861, respectively. Conclusion The combined application of VTIQ and BI-RADS is an effective supplementary to conventional images in diagnosis of minimal breast carcinoma.