CAJ | 학술논문

目的:研究乳腺肿块的常规超声与声脉冲辐射力成像技术(ARFI)的声像特点,探讨和比较ARFI在乳腺肿块良恶性鉴别诊断中的潜在临床应用价值.方法:分别采用常规超声和ARFI弹性成像技术对110例患者124个乳腺病灶进行检查.获取病灶的常规超声图像及ARFI超声弹性图和声触诊组织定量(VTQ)值,然后采用双盲法分别运用常规超声、ARFI对乳腺肿块的良恶性进行诊断分析.以病理(穿刺活检/手术切除)结果为金标准,对常规超声和ARFI鉴别诊断乳腺肿块良恶性的准确性进行评价,比较两种超声技术在乳腺肿块良恶性鉴别诊断中的诊断效能.结果:常规超声特点诊断乳腺良恶性肿瘤的敏感性、特异性、准确性及阳性预测值分别为80.00%、81.08%、80.77%及63.16%.ARFI诊断乳腺良恶性肿块的敏感性、特异性和准确性及阳性预测值分别为93%、96%、96%及93%.ARFI诊断乳腺肿块良恶性的诊断效能与常规超声比较,差异有统计学意义(P<0.05).结论:常规超声和ARFI对乳腺肿块的鉴别诊断均有一定的实用价值, ARFI对乳腺肿块的鉴别诊断效能要优于常规超声,两种技术联合使用可以发挥优势互补的作用,可明显提高乳腺肿块的鉴别诊断效能,降低漏诊率及误诊率.
목적:연구유선종괴적상규초성여성맥충복사력성상기술(ARFI)적성상특점,탐토화비교ARFI재유선종괴량악성감별진단중적잠재림상응용개치.방법:분별채용상규초성화ARFI탄성성상기술대110례환자124개유선병조진행검사.획취병조적상규초성도상급ARFI초성탄성도화성촉진조직정량(VTQ)치,연후채용쌍맹법분별운용상규초성、ARFI대유선종괴적량악성진행진단분석.이병리(천자활검/수술절제)결과위금표준,대상규초성화ARFI감별진단유선종괴량악성적준학성진행평개,비교량충초성기술재유선종괴량악성감별진단중적진단효능.결과:상규초성특점진단유선량악성종류적민감성、특이성、준학성급양성예측치분별위80.00%、81.08%、80.77%급63.16%.ARFI진단유선량악성종괴적민감성、특이성화준학성급양성예측치분별위93%、96%、96%급93%.ARFI진단유선종괴량악성적진단효능여상규초성비교,차이유통계학의의(P<0.05).결론:상규초성화ARFI대유선종괴적감별진단균유일정적실용개치, ARFI대유선종괴적감별진단효능요우우상규초성,량충기술연합사용가이발휘우세호보적작용,가명현제고유선종괴적감별진단효능,강저루진솔급오진솔.
Objective:To compare the value of conventional ultrasound(US)and acoustic radiation gorce impulse(ARFI)in the differential diagnosis of breast lesions,and discuss the differential diagnostic efficiency of ARFI in benign and malignant breast lesions. Method:One hundred and ten patients with one hundred and twenty-four lesions were examined by US and ARFI before surgery or puncture. The character of grayscale,color doppler ultrasound and ARFI were comparatively analyzed in the diagnosis of benign and malignant breast lesions,and the shear wave velocity(SWV)in the lesions and the surrounding normal breast tissue was measured. Result:To use surgical pathology as the gold standard,the mean VTQ value of malignant lesions,benign lesions and normal tissue is respectively as(5.19±1.54)m/s,(2.63±0.85)m/s,(1.82±0.57)m/s. The difference of VTQ between normal breast tissue,benign lesions,malignant lesions had a statistical significance(P<0.05). The sensitivity,specificity,accuracy,and positive predictive value of ARFI was 93%,96%,96%,and 93%,respectively. The sensitivity,specificity,accuracy,and positive predictive value of US was 80.00%,81.08%,80.77%,and 63.16%,respectively. Conclusion:ARFI can identify the elastic difference between breast lesions and normal breast tissue,it also can quantitatively evaluate the elasticity of various organization .In brief,ARFI has great better clinic value in differential diagnosis of benign and malignant diseases than conventional ultrasound.