超声弹性成像技术在乳腺肿块定性诊断中的应用

摘要

Objective:To investigate the diagnostic value of ultrasonic elastography technique(UE) in the diagnosis of breast masses. Methods:CUE examination was performed on 130 patients with 141 breast masses.The UE imaging were analyzed and given scores,then Acoustic Radiation Foce Impulse(ARFI) was used to conduct virtual touch tissue imaging(VTI)and virtual touch tissue quantification(VTQ).We analyzed the VTI elastic image features,rendered(ROC)curve,the VTQ values of benign and malignant breast masses and their surrounding tissues were analyzed.All cases were confirmed by biopsy or operation and pathology.Results:UE score method for the malignant breast masses displayed a clearer margin than the benign breast masses by VTI,the VTI area ratio of malignant breast masses was much larger than the benign breast masses,according to ROC curve,the malignant group was significantly higher than that of the benign group(P<0.001).The difference of VTQ values in the peripheral glands of benign and malignant breast tumors was statistically significant,and the malignant group was higher than that in the benign group(P<0.05). Conclusion:UE can make an objective evaluation of the hardness of the masses in differentiating benign and malignant breast masses,it is helpful to the diagnosis of benign and malignant breast masses.%目的：探讨超声弹性成像技术对乳腺肿块的定性诊断价值。方法：对130例患者共141个乳腺肿块行助力式弹性成像(CUE)检查，分析UE弹性图特征并进行UE评分，再应用声脉冲辐射力成像技术(ARFI)分别对其进行声触诊组织成像(VTI)及声触诊组织量化(VTQ)检查，分析VTI弹性图像特征，绘制受试者工作特征(ROC)曲线，分析良恶性乳腺肿块及其周围腺体组织的VTQ值差异。所有病例均经穿刺或手术病理证实。结果：UE评分法诊断乳腺恶性病灶，VTI图像边界清晰度要明显优于良性病灶；乳腺恶性肿块的VTI面积比明显大于良性肿块；依据ROC曲线，恶性组明显高于良性组(P＜0.001)。乳腺良恶性肿块周围腺体组织 VTQ 值差异有统计学意义，恶性组高于良性组(P＜0.05)。结论：UE在对乳腺肿块良恶性进行鉴别时能对肿块的硬度作出客观的评价，有助于超声对乳腺肿块良恶性的定性诊断。