声触诊组织成像定量技术鉴别诊断乳腺病灶良恶性及评价其异质性的应用价值  

Application of virtual touch tissue imaging quantification technology in differentiating benign or malignant breast lesions and evaluating the heterogeneity of breast lesions

作　　者：王颖 周玮珺[1] 孔文韬[1] 吴敏[1] Wang Ying;Zhou Weijun;Kong Wentao;Wu Min(Department of Ultrasound, Drum Tower Hospital Affliated to Nanjing University Medical School, Nanjing 210008, China)

机构地区：[1]南京大学医学院附属鼓楼医院超声诊断科,210008

出　　处：《中华医学超声杂志（电子版）》2017年第12期909-913,共5页Chinese Journal of Medical Ultrasound(Electronic Edition)

摘　　要：目的探讨声触诊组织成像定量(VTIQ)技术鉴别诊断乳腺病灶良恶性及评价其异质性的应用价值。方法选择2016年10月至2017年3月于南京大学医学院附属鼓楼医院行乳腺超声检查的患者149例,共155个病灶。所有患者均经手术病理证实。所有患者先行乳腺常规超声检查,记录乳腺病灶常规超声表现特征,并根据乳腺影像学报告及数据系统(BI-RADS)对乳腺病灶进行分类。然后在VTIQ模式下,测量病灶剪切波速度(SWV),获得SWV最大值、平均值,并计算SWV离散系数。以术后病理结果作为金标准,绘制SWV最大值、平均值及离散系数鉴别诊断乳腺良恶性病灶的受试者工作特征(ROC)曲线。结果手术病理证实,155个乳腺病灶中,恶性病灶48个,良性病灶107个。乳腺恶性病灶SWV最大值、平均值及离散系数均大于乳腺良性病灶^([(6.85±2.26)cm/svs(3.95±1.54)cm/s,(4.74±1.36)cm/s vs(3.10±0.94)cm,(0.30±0.15)vs(0.17±0.10)]),且差异均有统计学意义(t=8.085、7.583、5.366,P值均<0.001)。ROC曲线显示,SWV最大值、平均值及离散系数鉴别诊断乳腺病灶良恶性的曲线下面积分别为0.842、0.826、0.759,阈值分别为5.51 cm/s、4.28 cm/s、0.25。SWV最大值、平均值及离散系数鉴别诊断乳腺病灶良恶性的敏感度、特异度、准确性分别为72.92%、85.98%、81.93%,64.58%、87.85%、80.65%,64.58%、84.11%、78.06%。SWV最大值和SWV平均值分别联合SWV离散系数后,其鉴别诊断乳腺病灶良恶性的敏感度提高到81.25%。结论 VTIQ技术在鉴别诊断乳腺病灶良恶性及评价其异质性中有重要价值。Objective To investigate virtual touch tissue imaging quantification shear wave elastography in the differential diagnosis between benign and malignant breast lesions and the value of heterogeneity. Methods A total of 149 patients with 155 breast lesions by ultrasonography were selected from October 2016 to March 2017 in Drum Tower Hospital Affiliated to Nanjing University Medical School. All patients were confirmed by surgical pathology. The breast lesions were first examined by conventional ultrasound and the conventional ultrasonography features were recorded. The lesions were classified by breast imaging reporting and data system（BI-RADS）. Then the shear wave velocity（SWV） values were measured under the virtual touch tissue imaging quantification（VTIQ） speed mode. The SWV maximum, average were obtained and coefficient of variation was calculated. According to pathological results, the receiver operating characteristic（ROC） curves of SWV maximum, average and coefficient of variation in differentiating benign or malignant breast lesions were drawn. Results The surgical pathology confirmed that there were 48 malignant lesions and 107 benign lesions in 155 breast lesions. The SWV maximum, average and coefficient of variation in malignant lesions were all higher than those of benign lesions [（6.85±2.26） cm/svs（3.95±1.54） cm/s,（4.74±1.36） cm/s vs（3.10±0.94） cm,（0.30±0.15） vs（0.17±0.10）], and the difference was all statistically significant（t=8.085, 7.583, 5.366, all P〈0.001）. According to ROC curve, the areas under the curves of SWV maximum, average and coefficient of variation in differentiating benign or malignant breast lesions were 0.842, 0.826 and 0.759 and the cutoff values were 5.51 cm/s, 4.28 cm/s and 0.25 respectively. The diagnostic sensitivity, specificity and accuracy of SWV maximum, average and coefficient of variation were 72.92%, 85.98% and 81.93%, 64.58%, 87.85% and 80.65%, 64.58%, 84.11% and 78.06%, respectively. And the combined diagnostic sensit

关 键 词：弹性成像技术 乳腺疾病 异质性 

分 类 号：R445.1[医药卫生—影像医学与核医学] R655.8[医药卫生—诊断学] R737.9[医药卫生—临床医学]