CAJ | 학술논문

目的：探讨声脉冲辐射力成像(Acoustic Radiation Force Impulse，ARFI)技术在乳腺良恶性肿块鉴别诊断中的临床应用价值。方法：应用ARFI技术对81例患者共85个乳腺肿块进行声触诊组织成像(Virtual Touch Tissue Imaging ，VTI)及声触诊组织量化(Virtual Touch Tissue Quantification，VTQ)检查，VTI对肿块硬度进行评分， VTQ测量乳腺肿块内部剪切波速度(Shear Wave Velocity，SWV)，与术后病理结果对照，分析乳腺良、恶性组间的差异。结果：VTI评分及VTQ在乳腺良恶性组之间比较差异有统计学意义(0.001)。ROC曲线下面积分别为0.898±0.017[95%CI（0.865，0.931）,=0.000]，0.913±0.018[95%CI（0.878，0.947）,=0.000]，SWV为4.0m/s作为乳腺恶性结节的诊断截点，敏感性为97.2%，特异性为81%。VTI评分4分作为诊断乳腺恶性结节的截点敏感性为90%，特异性为70%。联合VTI评分及VTQ诊断的敏感性、特异性及准确性分别为92.3%、97.8%、95.2%。结论：ARFI技术通过定性及定量评价乳腺良恶性肿块的弹性成像，有助于乳腺良恶性肿块的鉴别诊断。
목적：탐토성맥충복사력성상(Acoustic Radiation Force Impulse，ARFI)기술재유선량악성종괴감별진단중적림상응용개치。방법：응용ARFI기술대81례환자공85개유선종괴진행성촉진조직성상(Virtual Touch Tissue Imaging ，VTI)급성촉진조직양화(Virtual Touch Tissue Quantification，VTQ)검사，VTI대종괴경도진행평분， VTQ측량유선종괴내부전절파속도(Shear Wave Velocity，SWV)，여술후병리결과대조，분석유선량、악성조간적차이。결과：VTI평분급VTQ재유선량악성조지간비교차이유통계학의의(0.001)。ROC곡선하면적분별위0.898±0.017[95%CI（0.865，0.931）,=0.000]，0.913±0.018[95%CI（0.878，0.947）,=0.000]，SWV위4.0m/s작위유선악성결절적진단절점，민감성위97.2%，특이성위81%。VTI평분4분작위진단유선악성결절적절점민감성위90%，특이성위70%。연합VTI평분급VTQ진단적민감성、특이성급준학성분별위92.3%、97.8%、95.2%。결론：ARFI기술통과정성급정량평개유선량악성종괴적탄성성상，유조우유선량악성종괴적감별진단。
Objective:To explore the clinical application value of Acoustic radiation force impulse (ARFI) technology in the differential diagnosis of benign and malignant breast masses. Methods:Eighty-one patients with 85 masses (39 malignant,46 benign)were studied with conventional ultrasound examination firstly, and then ARFI. Organization hardness score was evaluated by Virtual touch tissue imaging(VTI), the shear wave velocity(SMV) of the tumors was measured by virtual touch tissue quantification (VTQ). Measured result were compared with pathological results, drawed the ROC curve find the cut off value point of VTQ to predict breast cancer. The difference between benign and malignant masses was analyzed. Results:There was significant difference between benign and malignant groups ( 0.001). Areas of ROC curve of VTI scores and VTQ was sepreately 0.898±0.017[95%CI(0.865,0.931), =0.000] , 0.913±0.018 [95%CI (0.878,0.947), =0.000]. The cut-off value of VTI scores and SMV in diagnosis of malignangt masses were 4 scores and 4m/s, sensitivity and specificity of diagnosing breast cancer of 4 scores and 90%,70%, 4m/s were 81%,97.2%. Sensitivity,specificity and accuracy of the combination of VTI scores and VTQ were 92.3%, 97.8%,95.2%. Conclusions:ARFI provides qualitative and quantitative elasticity measurements of breast masses which can help improve the differentiate benign from malignant masses.