声脉冲辐射力成像技术对不同年资医生诊断乳腺实性病灶的辅助应用价值  

Application value of acoustic radiation force impulse technique in auxiliary diagnosis of solid breast lesions by doctors of different seniority

作　　者：贾妍[1] 蒲欢 刘娜[1] 彭娟[1] 郭瑞强[1] JIA Yan;PU Huan;LIU Na;PENG Juan;GUO Ruiqiang(Dept.of Medical Ultrasound,Renmin Hospital of Wuhan University,Wuhan 430060,Hubei,China)

机构地区：[1]武汉大学人民医院超声影像科,湖北武汉430060

出　　处：《武汉大学学报（医学版）》2022年第2期312-316,共5页Medical Journal of Wuhan University

摘　　要：目的:探讨声脉冲辐射力成像(ARFI)技术对不同年资医生诊断乳腺良恶性病灶的辅助应用价值。方法:由高年资医生及低年资医生分别对238例(病灶254个)乳腺实性肿块患者进行二维常规超声检查,并做出BI-RADS分类。应用声触诊组织成像(VTI)技术和声触诊组织量化成像(VTIQ)技术评估所有乳腺实性病灶弹性硬度情况,不同年资医生将二维常规超声与VTI、VTIQ结果相结合,对BI-RADS分类进行校正,并与病理结果对照。根据校正后结果,分析不同年资超声医生应用ARFI技术时是否能提高对乳腺良恶性病灶的诊断水平。结果:应用二维常规超声时,高年资医生组诊断水平高于低年资医生组,差异有统计学意义(P=0.025)。应用声脉冲辐射力成像检查时,VTI评分法及VTIQ成像技术对乳腺良恶性病灶均具有较高诊断效能,其中VTIQ成像剪切波速度(Vmean)可作为评估乳腺良恶性病灶的可靠指标,诊断界点值为4.84 m/s。应用ARFI技术校正BI-RADS分类时,低年资医生组诊断敏感度提高20.8%,特异度提高20.2%,准确性提高18.2%,高年资医生组诊断敏感度提高18.9%,特异度提高22.3%,准确性提高16.1%。结论:声脉冲辐射力成像技术对不同年资超声医生诊断乳腺良恶性病灶均有较大辅助诊断价值。Objective: To explore the value of acoustic radiation force impulse(ARFI) in the diagnosis of benign and malignant breast lesions by doctors with different years of experience. Methods: Two dimensional(2 D)conventional ultrasound examination was performed by senior and junior doctors in 238 cases(254 lesions) with solid breast masses, and BI-RADS classification was made. Virtual touch tissue imaging(VTI) and virtual touch image quantification(VTIQ) were used to evaluate the elastic hardness of all solid breast lesions. Doctors with different seniority adopted 2 D conventional ultrasound combined with VTI and VTIQ to correct the classification of BI-RADS, and the pathological results were also compared. Based on the results of calibration, we analyzed whether ultrasound doctors with different years of experience can improve the diagnosis level of benign and malignant breast diseases when applying ARFI. Results: When 2 D conventional ultrasound was applied, the diagnosis efficacy of the group with high seniority was higher than that of the group with low seniority, and the difference was statistically significant(P=0. 025). Through ARFI application, both VTI score method and VTIQ imaging technology showed high diagnostic efficiency for breast benign and malignant lesions, among which VTIQ imaging shear wave velocity(Vmean) can be used as a reliable index for evaluating breast benign and malignant lesions, and the diagnostic threshold value was 4. 84 m/s. When ARFI was applied to correct BI-RADS classification, the diagnostic sensitivity, specificity and accuracy of the low-seniority group increased by 20. 8%, 20. 2% and 18. 2%, respectively, and the diagnostic sensitivity, specificity and accuracy of the high-seniority group increased by 18. 9%, 22. 3% and16. 1%, respectively. Conclusion: Acoustic radiation force impulse technique is of great value for ultrasound doctors with different years of experience to diagnose benign and malignant breast lesions.

关 键 词：乳腺 超声 声脉冲辐射力成像 声触诊组织成像 声触诊组织成像量化 诊断效能 

分 类 号：R445.1[医药卫生—影像医学与核医学]