疑难病杂志
疑難病雜誌
의난병잡지
Chinese Journal of Difficult and Complicated Cases
2015年
11期
1158-1161
,共4页
张捷思%马琳%薛红元%翟秀兰%赵荣梅%李丽
張捷思%馬琳%薛紅元%翟秀蘭%趙榮梅%李麗
장첩사%마림%설홍원%적수란%조영매%리려
乳腺肿块%声辐射力脉冲成像%声触诊组织成像%声触诊组织量化%超声检查
乳腺腫塊%聲輻射力脈遲成像%聲觸診組織成像%聲觸診組織量化%超聲檢查
유선종괴%성복사력맥충성상%성촉진조직성상%성촉진조직양화%초성검사
Breast lesion%Acoustic radiation force impulse%Virtual touch image%Virtual touch quantification%Ultra-sonography
目的：探讨声辐射力脉冲成像技术（ ARFI）在乳腺病变中的诊断价值。方法对76个乳腺病灶进行声触诊组织成像（ VTI）及声触诊组织量化（ VTQ），对VTI图像进行评分并测量肿块在VTI图像面积与二维图像面积比（ AR），用VTQ检查测量其剪切波速度（ SWV），包括病灶内部、周边组织及对侧同深度正常腺体组织。所有病例根据病理结果构建ROC曲线，评价该技术对乳腺肿块的诊断效能，并寻找各参数的诊断界值。结果 AR值及SWV值的ROC曲线下面积分别为0趑．84、0．83，二者诊断效能比较差异无统计学意义（ Z ＝0．24， P ＞0．05）。以VTI评分≥4分，AR值≥1．52，SWV测值≥3．70 m／s为诊断界值，3个参数单独诊断的准确率、敏感度、特异度分别为85．5％、73．1％、92．0％；81．6％、65．4％、90．0％；84．2％、69．2％、92．0％。3个参数联合诊断的准确率、敏感度、特异度别为90．8％、96．2％、88．0％，3个参数联合诊断乳腺肿块的诊断效能优于单个参数（ P ＜0．05）。结论 VTI及VTQ技术对乳腺良、恶性肿块的鉴别诊断均有一定的临床应用价值，2种技术联合使用可明显提高乳腺肿块的诊断效能。
目的：探討聲輻射力脈遲成像技術（ ARFI）在乳腺病變中的診斷價值。方法對76箇乳腺病竈進行聲觸診組織成像（ VTI）及聲觸診組織量化（ VTQ），對VTI圖像進行評分併測量腫塊在VTI圖像麵積與二維圖像麵積比（ AR），用VTQ檢查測量其剪切波速度（ SWV），包括病竈內部、週邊組織及對側同深度正常腺體組織。所有病例根據病理結果構建ROC麯線，評價該技術對乳腺腫塊的診斷效能，併尋找各參數的診斷界值。結果 AR值及SWV值的ROC麯線下麵積分彆為0趑．84、0．83，二者診斷效能比較差異無統計學意義（ Z ＝0．24， P ＞0．05）。以VTI評分≥4分，AR值≥1．52，SWV測值≥3．70 m／s為診斷界值，3箇參數單獨診斷的準確率、敏感度、特異度分彆為85．5％、73．1％、92．0％；81．6％、65．4％、90．0％；84．2％、69．2％、92．0％。3箇參數聯閤診斷的準確率、敏感度、特異度彆為90．8％、96．2％、88．0％，3箇參數聯閤診斷乳腺腫塊的診斷效能優于單箇參數（ P ＜0．05）。結論 VTI及VTQ技術對乳腺良、噁性腫塊的鑒彆診斷均有一定的臨床應用價值，2種技術聯閤使用可明顯提高乳腺腫塊的診斷效能。
목적：탐토성복사력맥충성상기술（ ARFI）재유선병변중적진단개치。방법대76개유선병조진행성촉진조직성상（ VTI）급성촉진조직양화（ VTQ），대VTI도상진행평분병측량종괴재VTI도상면적여이유도상면적비（ AR），용VTQ검사측량기전절파속도（ SWV），포괄병조내부、주변조직급대측동심도정상선체조직。소유병례근거병리결과구건ROC곡선，평개해기술대유선종괴적진단효능，병심조각삼수적진단계치。결과 AR치급SWV치적ROC곡선하면적분별위0자．84、0．83，이자진단효능비교차이무통계학의의（ Z ＝0．24， P ＞0．05）。이VTI평분≥4분，AR치≥1．52，SWV측치≥3．70 m／s위진단계치，3개삼수단독진단적준학솔、민감도、특이도분별위85．5％、73．1％、92．0％；81．6％、65．4％、90．0％；84．2％、69．2％、92．0％。3개삼수연합진단적준학솔、민감도、특이도별위90．8％、96．2％、88．0％，3개삼수연합진단유선종괴적진단효능우우단개삼수（ P ＜0．05）。결론 VTI급VTQ기술대유선량、악성종괴적감별진단균유일정적림상응용개치，2충기술연합사용가명현제고유선종괴적진단효능。
Objective To investigate the diagnostic value of acoustic radiation force impulse imaging ( ARFI) in the diagnosis of breast lesions.Methods There were 76 breast lesions underwent acoustic palpation of tissue imaging ( VTI) and acoustic touch tissues quantification ( VTQ) , scored and measured mass’ s VTI image area and the two-dimensional image area ratio ( AR) , using VTQ to measure the shear wave velocity ( SWV) of VTI images, including inner of the lesion and surround-ing tissue and off-side’ s same depth’ s normal thyroid tissue.All cases were constructed according to the pathological results of the ROC curve, the diagnostic efficacy of the technique for breast masses was evaluated, and the diagnostic values of all pa-rameters were determined.Results AR and SWV values under the ROC curve area were 0.84 and 0.83, differences between the two diagnostic efficacy showed no statistical significance ( Z =0.24, P >0.05).VTI score greater than or equal to 4 points, AR value greater than or equal to 1.52, SWV measured value higher than or equal to 3.70 m/s as the diagnosis cutoff values, the three parameters’ diagnosis accurate rate, sensitivity, specificity were 85.5%, 73.1%and 92.0%;81.6%and 65.4%, 90.0%and 84.2%, 69.2% and 92.0%, respectively.Three parameters combination’ s diagnosis accurate rate, sensitivity, specificity were 90.8%, 96.2% and 88.0%, respectively.Three parameters combination’ s diagnosis efficacy was better than that of single parameter ( P <0.05).Conclusion VTI and VTQ have certain clinical application value in the differential diagnosis of benign and malignant breast tumors.2 kinds of techniques can improve the diagnostic efficiency of breast tumor.
