声触诊组织定量技术在触诊阴性乳腺实性肿块诊断方面的应用

摘要

目的 探讨声触诊组织定量(virtual touch tissue quantification,VTQ)技术在触诊阴性乳腺肿块诊断方面的应用价值.方法 对176例患者201个触诊阴性乳腺病灶行常规超声检查及VTQ检查,以病理诊断为金标准,通过构建ROC曲线,评价VTQ技术在触诊阴性乳腺实性肿块方面的诊断价值.结果 触诊阴性乳腺恶性病灶剪切波速度(speed wave velocity,SWV)远大于良性病灶[(6.17±1.95) m/s对(3.39±1.82)m/s,P＜0.01];VTQ与BI-RADS-US标准的曲线下面积分别为0.789和0.840,两者比较差异无统计学意义(P＞0.05);两种方法联合应用构建ROC曲线的曲线下面积为0.934,与分别单独应用BI RADS-US标准及VTQ技术比较,差异均有统计学意义(P＜0.01).结论 VTQ技术有助于触诊阴性乳腺病灶的良恶性评估,常规超声与VTQ技术联合应用在判断触诊阴性乳腺病灶的良恶性方面具有重要的临床应用价值.%Objective To evaluate the diagnostic value of virtual touch tissue quantification (VTQ) for nonpalpable breast masses.Methods Two hundred and one nonpalpable breast masses in 176 women who had been scheduled for a sonographically guided core biopsy or operation were examined with the B-mode sonography and VTQ.The pathologic diagnosis was used as the golden standard.The diagnostic performances of the two methods were evaluated with receiver operating characteristic curve(ROC).Results The mean shear wave velocity (SWV) measurement values were (6.17 ± 1.95)m/s in malignant masses and (3.39± 1.82)m/s in benign masses(P ＜0.01),respectively.The area under the ROC curve was 0.789 for the VTQ and 0.840 for the BI-RADS-US,respectively.No statistically difference was found between them.The area under the ROC curve of the combination of the two methods was 0.934,the diagnostic performance of the combination was better than that of BLRADS-US(P ＜0.01)and VTQ alone (P ＜0.01).Conclusions VTQ is a good method for diagnosing nonpalpable breast lesions.The combination of BI-RADS-US and VTQ has better diagnostic perform ance for differentiation of nonpalpable breast lesions,which has important value in clinical application.