常规超声与声脉冲辐射力成像鉴别诊断乳腺肿块良恶性的对比研究  

Comparative Study of Conventional Ultrasound and Acoustic Radiation Force Impulse(ARFI)in the Differential Diagnosis of Benign and Malignant Lesions

作　　者：张露[1] 周平[1] 邓金[1] 田双明[1] 钱滢[1] 伍晓敏[1] 马树花[1] 

机构地区：[1]中南大学湘雅三医院,湖南长沙410013

出　　处：《中国医学创新》2013年第6期100-103,共4页Medical Innovation of China

摘　　要：目的:研究乳腺肿块的常规超声与声脉冲辐射力成像技术(ARFI)的声像特点,探讨和比较ARFI在乳腺肿块良恶性鉴别诊断中的潜在临床应用价值。方法:分别采用常规超声和ARFI弹性成像技术对110例患者124个乳腺病灶进行检查。获取病灶的常规超声图像及ARFI超声弹性图和声触诊组织定量(VTQ)值,然后采用双盲法分别运用常规超声、ARFI对乳腺肿块的良恶性进行诊断分析。以病理(穿刺活检/手术切除)结果为金标准,对常规超声和ARFI鉴别诊断乳腺肿块良恶性的准确性进行评价,比较两种超声技术在乳腺肿块良恶性鉴别诊断中的诊断效能。结果:常规超声特点诊断乳腺良恶性肿瘤的敏感性、特异性、准确性及阳性预测值分别为80.00%、81.08%、80.77%及63.16%。ARFI诊断乳腺良恶性肿块的敏感性、特异性和准确性及阳性预测值分别为93%、96%、96%及93%。ARFI诊断乳腺肿块良恶性的诊断效能与常规超声比较,差异有统计学意义(P<0.05)。结论:常规超声和ARFI对乳腺肿块的鉴别诊断均有一定的实用价值,ARFI对乳腺肿块的鉴别诊断效能要优于常规超声,两种技术联合使用可以发挥优势互补的作用,可明显提高乳腺肿块的鉴别诊断效能,降低漏诊率及误诊率。Objective：To compare the value of conventional ultrasound（US）and acoustic radiation gorce impulse（ARFI）in the differential diagnosis of breast lesions,and discuss the differential diagnostic efficiency of ARFI in benign and malignant breast lesions. Method：One hundred and ten patients with one hundred and twenty-four lesions were examined by US and ARFI before surgery or puncture. The character of grayscale,color doppler ultrasound and ARFI were comparatively analyzed in the diagnosis of benign and malignant breast lesions,and the shear wave velocity（SWV）in the lesions and the surrounding normal breast tissue was measured. Result：To use surgical pathology as the gold standard,the mean VTQ value of malignant lesions,benign lesions and normal tissue is respectively as（5.19±1.54）m/s,（2.63±0.85）m/s,（1.82±0.57）m/s. The difference of VTQ between normal breast tissue,benign lesions,malignant lesions had a statistical significance（P〈0.05）. The sensitivity,specificity,accuracy,and positive predictive value of ARFI was 93%,96%,96%,and 93%,respectively. The sensitivity,specificity,accuracy,and positive predictive value of US was 80.00%,81.08%,80.77%,and 63.16%,respectively. Conclusion：ARFI can identify the elastic difference between breast lesions and normal breast tissue,it also can quantitatively evaluate the elasticity of various organization .In brief,ARFI has great better clinic value in differential diagnosis of benign and malignant diseases than conventional ultrasound.

关 键 词：乳腺肿块 常规超声检查 ARFI 鉴别诊断 

分 类 号：R445.1[医药卫生—影像医学与核医学]