自动乳腺全容积成像与声触诊组织成像量化对乳腺良恶性病变的鉴别诊断价值  

Values of ABVS and VTIQ in differential diagnosis of benign and malignant breast lesions

作　　者：朱婷 刘涛 车欣 伍珑 胡蓉菲 ZHU Ting;LIU Tao;CHE Xin;WU Long;HU Rong-fei(Department of Ultrasound, Renhe Hospital, Baoshan District, Shanghai 200431, China;Community Health Service Center of Youyi Street, Baoshan District, Shanghai 201999, China)

机构地区：[1]上海市宝山区仁和医院超声科,上海200431 [2]上海市宝山区友谊街道社区卫生服务中心,上海201999

出　　处：《中国临床医学》2021年第2期283-287,共5页Chinese Journal of Clinical Medicine

基　　金：上海市宝山区科学技术委员会资助项目(20-E-28).

摘　　要：目的:探讨自动乳腺全容积成像(ABVS)与声触诊组织成像量化(VTIQ)技术对乳腺良恶性病变的鉴别诊断价值。方法:选取2018年8月至2019年7月上海市宝山区仁和医院收治的女性乳腺疾病患者200例,共260个肿块,均进行ABVS及VTIQ检测。以手术或穿刺活检病理结果为金标准,对比2种方法及2种方法联合在乳腺良恶性病变鉴别中的灵敏度、特异度和准确度。结果:260个肿块中,恶性结节68个,良性结节192个。恶性肿块中ABVS冠状面“汇聚征”的出现率明显高于良性肿块(42.6%vs 2.1%,P<0.05),以出现“汇聚征”作为鉴别乳腺肿块良恶性的标准,其灵敏度、特异度、准确度分别为36.83%、91.73%、85.89%。VTIQ检测发现恶性肿块的平均剪切波速度(shear wave velocity,SWV)显著高于良性肿块[(5.92±1.53)m/s vs(2.58±1.17)m/s,P<0.01];以SWV 3.65 m/s为阈值鉴别乳腺良恶性肿块的灵敏度、特异度、准确度分别为94.99%、69.82%、84.31%。ABVS联合VTIQ鉴别乳腺良恶性肿块的灵敏度、特异度、准确度分别为96.81%、87.72%、96.78%。受试者工作特征(ROC)曲线显示,ABVS联合VTIQ鉴别诊断乳腺良恶性肿块的曲线下面积(AUC)为0.983,大于ABVS和VTIQ(0.852、0.924)。结论:ABVS和VTIQ技术在鉴别乳腺良恶性肿块中均有较高的价值,ABVS联合VTIQ鉴别诊断准确度更高,可广泛应用于临床。Objective:To explore the application value of automated breast volume scanner(ABVS)and virtual-touch tissue imaging quantification(VTIQ)techniques in the diagnosis of benign and malignant breast lesions.Methods:A total of 260 breast lumps in 200 patients with breast diseases treated in Renhe Hospital,Baoshan District of Shanghai from August 2018 to July 2019 were selected.All patients were female and examined with ABVS and VTIQ.The sensitivity,specificity,and accuracy of the two methods in the differentiation of benign and malignant breast lesions were compared under single and combined application according to a gold operation or aspiration biopsy results.Results:Among the 260 masses,68 were malignant nodules and 192 were benign nodules.The incidence of“fusion sign”on ABVS coronal view in malignant masses was significantly higher than that in benign masses(42.6%vs 2.1%,P<0.05).The sensitivity,specificity,and accuracy were 36.83%,91.73%,and 85.89%,respectively using“fusion sign”as the criteria for identifying benign and malignant breast masses.The mean shear wave velocity(SWV)of malignant masses was significantly higher than that of benign masses([5.92±1.53]m/s vs[2.58±1.17]m/s,P<0.01)by VTIQ test.The sensitivity,specificity,and accuracy were 94.99%,69.82%,and 84.31%,respectively using SWV 3.65 m/s as a threshold for the identification of breast benign and malignant masses.The sensitivity,specificity,and accuracy of ABVS combined with VTIQ were 96.81%,87.72%,and 96.78%,respectively.The area under the ROC(AUC)of ABVS combined with VTIQ in the differential diagnosis of breast benign and malignant masses was 0.983,which was higher than that of ABVS(0.852)and VTIQ(0.924).Conclusions:Both ABVS and VTIQ techniques have high value in differentiating breast benign and malignant masses.Moreover,the combined use of the two methods is more accurate in the diagnosis,which can be widely used in clinical practice.

关 键 词：乳腺癌 自动乳腺全容积成像 声触诊组织成像量化 BI-RADS评分 鉴别诊断 

分 类 号：R737.9[医药卫生—肿瘤]