声触诊组织成像定量技术在BI-RADS 4类乳腺非囊性结节中的应用研究  

Application of virtual touch tissue imaging quantification technique in BI-RADS type 4 breast non-cystic nodules

作　　者：王爱珠 黄旴宁 王宾[1] 王乐华[1] WANG Aizhu;HUANG Xuning;WANG Bin;WANG Lehua(Department of Ultrasound Medicine,Second Affiliated Hospital of Hainan Medical College,Haikou,Hainan 570311,China)

机构地区：[1]海南医学院第二附属医院超声医学科

出　　处：《重庆医学》2020年第5期766-769,共4页Chongqing medicine

基　　金：海南省卫生计生行业科研项目（18A200017）

摘　　要：目的探讨声触诊组织成像定量(VTIQ)技术鉴别乳腺影像报告和数据系统(BI-RADS)4类乳腺非囊性结节良恶性的应用价值,并对其中4A类结节进行优化。方法收集2017年3月至2018年9月106例经该院超声诊断为BI-RADS 4类乳腺非囊性结节的女性患者的影像资料,包括常规超声及VTIQ图像。通过计算获取VTIQ图像上结节内部剪切波速度(SWV)的平均值,以病理结果为金标准,采用t检验比较乳腺良、恶性结节SWV平均值的差异;绘制受试者工作特征(ROC)曲线,确定最佳截断值,获得曲线下面积(AUC),并以最佳截断值评估VTIQ技术对BI-RADS 4A类结节的优化效能。结果106个非囊性结节中,良性结节63个,恶性结节43个。VTIQ技术测定乳腺良、恶性结节的SWV平均值分别为(2.79±0.45)m/s及(4.58±0.99)m/s,差异有统计学意义(t=10.59,P=0.000)。SWV以3.47 m/s为最佳截断值,诊断BI-RADS 4类乳腺非囊性结节的灵敏度、特异度、准确度、阳性预测值、阴性预测值、约登指数及AUC分别为83.72%、87.30%、85.85%、81.82%、88.71%、0.710、0.915。以最佳截断值对62个4A类结节进行优化,有55个结节SWV平均值小于最佳截断值,55个乳腺结节可下调为3类以避免活检或手术,仅1个结节漏诊。结论VTIQ技术在BI-RADS 4类乳腺非囊性结节的鉴别诊断中有较好的诊断效能,并能有效优化乳腺4A类结节。Objective To investigate the application value of virtual touch tissue imaging quantification(VTIQ)technique in the differential diagnosis of benign and malignant non-cystic nodules of BI-RADS type 4 breast,and to optimize the 4A type nodules.Methods The imageological data of 106 female patients undergoing ultrasound diagnosis of BI-RADS 4 breast non-cystic nodules in the hospital from March 2017 to September 2018 were collected,including conventional ultrasound and VTIQ images.The average value of the internal shear wave velocity(SWV)of the nodule on the VTIQ image was obtained by calculation.The pathological result served as the gold standard.The t test was used to compare the difference of the mean SWV of the benign and malignant nodules.The receiver operator characteristic(ROC)curve was drawn.The optimal cutoff value was determined and the area under the curve(AUC)was obtained.The optimal cutoff value was used to evaluate the optimal efficiency of the VTIQ technique for BI-RADS 4A nodules.Results Of the 106 non-cystic nodules,63 nodules were benign and 43 nodules were malignant.The mean SWV values of benign and malignant nodules of the breast were(2.79±0.45)m/s and(4.58±0.99)m/s respectively,and the difference was statistically significant(t=10.59,P=0.000).The SWV mean value 3.47 m/s served as the optimal cutoff value,its sensitivity,specificity,accuracy,positive predictive value,negative predictive value,Yoden index and AUC for diagnosing BI-RADS type 4 breast non-cystic nodules were 83.72%,87.30%,85.85%,81.82%,88.71%,0.710,0.915 respectively.Optimization of 624A nodules with optimal cutoff values,the SWV mean value in 55 nodules was less than optimal cutoff,55 breast nodules could be downgraded to the class 3 to avoid biopsy or surgery,only 1 nodule missed diagnosis.Conclusion The VTIQ technology has a good diagnostic efficiency in the differential diagnosis of BI-RADS type 4 breast non-cystic nodules,and can effectively optimize breast 4A nodules.

关 键 词：乳腺非囊性结节 超声 乳腺影像报告和数据系统 声触诊组织成像定量 

分 类 号：R445.1[医药卫生—影像医学与核医学]