超声助力式弹性成像和声触诊组织成像量化技术对浅表软组织肿物诊断的价值

目的探讨超声助力式弹性成像(EI)和声触诊组织成像量化(VTQ)技术对浅表软组织肿物的诊断价值。方法回顾性收集经活检或手术病理证实且常规超声诊断有浅表软组织肿物的病人50例,共64个肿物。采用常规超声测量肿物大小、纵横比并观察其形态、边界、内部回声等指标,彩色多普勒观察血流信号,采用助力式EI获得肿物的弹性影像,并进行半定量评分,采用VTQ技术测量剪切波速度(SWV)。以病理结果为金标准,计算常规超声、EI评分和VTQ技术对良恶性浅表软组织肿物的诊断效能。采用Wilcoxon秩和检验比较良恶性肿物间的SWV,绘制SWV的受试者操作特征(ROC)曲线,计算ROC曲线下面积(AUC)。结果64个肿物中,病理诊断良性肿物51个,恶性肿物13个。常规超声诊断浅表软组织肿物良恶性的敏感度、特异度、准确度分别为76.9%(10/13)、90.2%(46/51)、87.5%(56/64),EI诊断的敏感度、特异度、准确度分别为76.9%(10/13)、88.2%(45/51)、85.9%(55/64),EI联合常规超声诊断的敏感度、特异度及准确度分别为84.6%(11/13)、94.1%(48/51)、92.2%(59/64)。VTQ检测恶性肿物的SWV高于良性肿物(P<0.05)。取SWV值2.995 m/s作为诊断阈值时,VTQ鉴别诊断肿物良恶性的AUC为0.983,其敏感度、特异度分别为92.3%、90.2%。结论EI弹性评分可半定量反映肿物组织的硬度信息,VTQ可定量评估肿物组织硬度弹性特征,两种成像模式对鉴别诊断浅表软组织肿物良恶性有一定价值。

The value of ultrasound-assisted elasticity imaging and virtual touch tissue quantification in the diagnosis of superficial soft tissue masses

Objective To investigate the value of ultrasound assisted elasticity imaging(EI)and virtual touch tissue quantification(VTQ)in the diagnosis of superficial soft tissue masses.Methods Fifty patients underwent conventional ultrasound.A total of 64 superficial soft tissue lesions were examined.The sizes and espect ratio of the lesions were measured on conventional ultrasound,and the morphology,boundary,internal echo and other indicators were observed.Color doppler was used to observe blood flow signal.Elastic images of lesions were obtained from power assisted EI for semi-quantitative evaluation.Shear wave velocity(SWV)was measured with VTQ technique.The diagnostic efficacies of conventional ultrasound,EI score and VTQ for benign and malignant superficial soft tissue masses were calculated by using the pathological results as gold standard.Wilcoxon rank sum test was used to compare SWV between benign and malignant masses.Reciever operating characteristic(ROC)analysis was done with SWV,and the area under ROC curve(AUC)was calculated.Results Among the 64 lesions,51 benign masses and 13 malignant masses were identified by pathology analysis.The sensitivity,specificity and accuracy of conventional ultrasound in the diagnosis of superficial soft tissue masses were 76.9%(10/13),90.2%(46/51)and 87.5%(56/64).The sensitivity,specificity and accuracy of EI were 76.9%(10/13),88.2%(45/51)and 85.9%(55/64).The sensitivity,specificity and accuracy of EI combined with conventional ultrasound were 84.6%(11/13),94.1%(48/51)and 92.2%(59/64).The SWV of malignant tumor detected was higher than that of benign tumor(P<0.05).When SWV value of 2.995 m/s was used as the diagnostic threshold,the AUC of VTQ in the differential diagnosis of benign and malignant tumor was 0.983,and its sensitivity and specificity were 92.3%and 90.2%,respectively.Conclusion EI elasticity score can semi-quantitatively reflect the hardness of tumor tissue,while VTQ can quantitatively evaluate the hardness and elasticity characteristics of tumor tissue.The two imaging techniques show diagnostic value in differentiating benign from malignant superficial soft tissue masses.