声辐射脉冲力技术定量鉴别诊断良恶性乳腺肿块

目的 探讨声辐射脉冲力(ARFI)技术在定量诊断乳腺良恶性肿块中的应用价值.方法 对175例患者227个乳腺肿块进行常规二维、彩色多普勒超声检查,同时采用ARFI技术测量剪切波速度(SWV),取样框分别置于肿块内部、肿块与周围腺体组织交界处以及周围腺体组织,以病理结果为金标准.结果 良性肿块内部及交界处SWV分别为(2.38士0.52)m/s、(2.14±0.61)m/s；恶性肿块内部及交界处SWV分别为(7.62士2.51)m/s、(5.32±2.63)m/s.恶性肿块内部及交界处SWV值均明显高于良性肿块(P均＜0.05)；良性肿块内部与交界处SWV值均明显高于周围腺体(P均＜0.05).绘制ROC曲线,以3.29 m/s为分界值,ARFI技术诊断良恶性肿块的敏感度为78.9％,特异度为98.3％,准确率为77.5％,曲线下面积为0.914.结论 ARFI在乳腺良恶性肿块诊断与鉴别诊断中具有重要临床意义.

Acoustic radiation force impulse technology in quantitative differential diagnosis of benign and malignant breast lesions

Objective: To explore the clinical application of acoustic radiation force impulse (ARFI) technology in quantitative differential diagnosis of benign and malignant breast lesions. Methods: Totally 175 patients with 227 breast lesions were included and underwent B mode ultrasonography and CDFI. Shear wave velocity (SWV) was measured using ARFI,and ROI was respectively placed in the internal of the lesion, marginal between the lesion and the parenchyma and peripheral parenchyma. Pathological results were taken as golden standards. Results: The internal and marginal SWV of the benign lesions was (2.38±0.52)m/s, and (2.14±0.61)m/s, while of malignant lesions was (7.62±2.51)m/s and (5.32±2.63)m/s, respectively. The internal and marginal SWV of malignant lesions were higher than those of benign lesions (both P<0.05). The internal and marginal SWV of benign lesions were higher than those of peripheral parenchyma (both P<0.05). With the cutoff value of 3.29 m/s, the sensitivity, specificity, accuracy of ARFI to predict malignancy was 78.9%, 98.3%, 77.5%, respectively, and the area under the curve was 0.914. Conclusion: ARFI has very high clinic value for diagnosis and differential diagnosis of benign and malignant breast lesions.