声触诊组织成像与定量技术与常规超声在乳腺癌腋窝淋巴结定性诊断中的价值  

Virtual touch tissue imaging quantification and conventional ultrasound in diagnosis of metastatic axillary lymph nodes in patients with breast cancer

作　　者：兰梦 刘爱莲[2] 兰天翔[3] 范凤景 郭丹 盛璇 丁红宇[2] Lan Meng;Liu Ailian;Lan Tianxiang;Fan Fengjing;Guo Dan;Sheng Xuan;Ding Hongyu(Taishan Medical University,Taian 271000,China;Department of Ultrasound,Qianfoshan Hospital Affiliated to Shandong University,Jinan 250014,China;Jinan Railway Center for Disease Control and Prevention,Jinan 250001,China)

机构地区：[1]泰山医学院,山东泰安271000 [2]山东大学附属千佛山医院超声诊疗科,济南250014 [3]济南铁路疾病预防控制中心,济南250001

出　　处：《中华临床医师杂志（电子版）》2019年第4期281-285,共5页Chinese Journal of Clinicians(Electronic Edition)

摘　　要：目的探讨声触诊组织成像与定量(VTIQ)技术与常规超声在乳腺癌腋窝淋巴结良恶性诊断中的价值。方法选取2017年6月至2018年3月于山东省千佛山医院行超声检查并病理证实的107例乳腺癌患者的107个腋窝淋巴结,进行常规超声评分及剪切波速度(SWV)值的测量,以病理结果为标准,绘制受试者工作特征曲线确定良恶性的最佳诊断界值。比较常规超声、VTIQ及两者并联法和串联法联合诊断的诊断价值。结果恶性腋窝淋巴结的SWVmax、SWVmin、SWVmean及常规超声评分均高于良性淋巴结,差异具有统计学意义(P<0.01)。常规超声评分≥6分,SWVmean值≥1.88 m/s时,腋窝淋巴结恶性的可能性大。VTIQ诊断的敏感度和特异度略高于常规超声,但差异无统计学差异。并联法的诊断敏感度高于常规超声(94.4% vs 70.4%),串联法的诊断特异度高于常规超声(96.2% vs 79.2%),差异均具有统计学意义(P<0.05)。结论VTIQ技术及常规超声均可对腋窝淋巴结良恶性提供有价值的信息,联合使用常规超声及VTIQ可有助于提高超声对乳腺癌腋窝淋巴结性质诊断的能力。Objective To evaluate the value of virtual touch tissue imaging quantification (VTIQ) and conventional ultrasound (US) in the diagnosis of axillary lymph nodes in breast cancer patients. Methods Totally, 107 axillary lymph nodes of 107 patients were measured by conventional US and VTIQ from June 2017 to March 2018 in QianFoshan Hospital of Shandong Province. The US score and the shear wave velocity (SWV) values were obtained. According to pathology results, receiver operating characteristic curve analysis was performed to find the optimal cut-off point in differentiating malignant from benign lesions. The diagnostic value of US, VTIQ, and concurrent and sequential combination of the two were compared. Results SWVmax, SWVmin, and SWVmean values of malignant lymph nodes were significantly higher than those of benign lymph nodes (P<0.01). When the US score ≥ 6 or the SWVmean ≥ 1.88 m/s, the lymph nodes were more likely to be malignant. The specificity and accuracy of VTIQ were higher than those of US, but there were no statistically significant differences between them. The sensitivity of the concurrent combination was significantly higher than that of conventional US (94.4% vs 70.4%, P<0.05), and the specificity of the sequential combination was significantly higher than that of conventional US (96.2% vs 79.2%, P<0.05). Conclusion Conventional US and VTIQ can help to diagnose axillary lymph nodes. The combination of conventional US and VTIQ can effectively improve the ability of ultrasound in the diagnosis of benign and malignant axillary lymph nodes.

关 键 词：乳腺癌 腋窝淋巴结 超声 声触诊组织成像 

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