常规超声、压迫式弹性成像及声脉冲辐射力成像鉴别诊断良恶性乳腺肿瘤的对比研究

目的：比较常规超声、压迫式弹性成像(compression elastography，CE)及声脉冲辐射力成像(acoustic radiation force impulse imaging，ARFI)3种超声检查技术鉴别诊断良恶性乳腺肿瘤的潜在临床应用价值。方法：对98例共117个乳 腺肿瘤行常规超声、CE以及ARFI检查，获取乳腺肿瘤的二维及彩色多普勒声像图、CE的弹性评分和弹性应变率比值 (SR)、ARFI的声触诊组织定量(VTQ)值，以病理结果作为诊断金标准，鉴别诊断乳腺肿瘤的良恶性，并评价3种超声 技术的诊断效能。结果：常规超声诊断乳腺恶性肿瘤的敏感性、特异性和准确性分别为80.0%，81.0%，81.7%。弹性 评分法诊断乳腺恶性肿瘤的敏感性、特异性、准确性分别为85.7%，86.7%，86.3%。SR截断点为3.71时，其诊断乳腺恶 性肿瘤的敏感性、特异性、准确性分别为97.1%，83.3%，88.4%。VTQ截断点为3.78 m/s时，其诊断乳腺恶性肿瘤的敏 感性、特异性、准确性分别为94.3%，91.7%，92.6%。ARFI，CE及常规超声诊断乳腺肿块良恶性的诊断效能比较差异 有统计学意义(P<0.05)。结论：常规超声、CE及ARFI对乳腺肿瘤的鉴别诊断均有一定的临床应用价值，其中ARFI的 鉴别诊断效能要优于CE和常规超声。3种技术可以取长补短，优势互补。

Contrastive study on conventional ultrasound,compression elastography and acoustic radiation force impulse imaging in the differential diagnosis of benign and malignant breast tumors

Objective: To evaluate the diagnostic performance of conventional ultrasound, compression elastography (CE) and acoustic radiation force impulse imaging (ARFI) in diff erential diagnosis of benign and malignant breast tumors. Methods: A total of 98 patients with liver lesions were included in the study. The images of conventional ultrasound, CE and the values of virtual touch tissue quantification (VTQ) of breast lesions were obtained. The diagnostic performance of conventional ultrasound, CE and ARFI were assessed by using pathology as the gold standard, and then evaluate the diagnosis efficiency of these three approaches in differential diagnosing benign and malignant breast tumors. Results: The specificity, sensitivity and accuracy in the diagnosis of malignant breast tumors for conventional ultrasound were 80.0%, 81.1% and 81.7%, respectively, whereas for CE elastic score were 85.7%, 86.7% and 86.3%, respectively. With a cutoff value of 3.71 for the SR, the sensitivity, specificity, accuracy in diagnosis of malignant breast tumors were 97.1%, 83.3% and 88.4%, respectively. With a cutoff value of 3.78 m/s for VTQ, the sensitivity, specificity, accuracy in diagnosis of malignant breast tumors were 94.3%, 91.7% and 92.6%, respectively. The difference in diagnosis efficiency among ARFI, CE and conventional ultrasound in differential diagnosis of benign and malignant breast tumors was significant (P<0.05). Conclusion: Conventional ultrasound, CE and ARFI are all useful for the differential diagnosis of benign and malignant breast tumors. But the diagnosis efficiency of ARFI is superior to CE and conventional ultrasound. The three approaches can help each other in differential diagnosis of benign and malignant breast tumors.