目的 利用声辐射力脉冲成像技术(ARFI)测量剪切波速度(SWV)的方法定量评价正常乳腺组织及乳腺肿块的硬度,分析其对乳腺良、恶性肿块鉴别诊断的临床价值.方法 利用常规超声和ARFI技术对101例患者的正常乳腺组织及146枚肿块进行检查,测量正常乳腺组织及乳腺肿块的SWV值.对结果进行对比分析,鉴别诊断肿块良、恶性.结果 正常乳腺腺体组织的SWV值为(1.63±0.47) m/s,乳腺良性肿块的SWV值为(2.38±0.55) m/s,恶性肿块的SWV值为(7.34±1.76) m/s.正常乳腺组织、乳腺良性肿块及恶性肿块SWV值之间的差异有统计学意义(P＜0.05).以实性肿块中央部位SWV值为xxx m/s为诊断乳腺恶性肿瘤的标准,ARFI诊断乳腺恶性肿瘤的敏感性、特异性、准确度及阳性预测值分别为90.0％、100％、97.9％、100％.该标准结合BIRADS分类,诊断乳腺恶性肿瘤的敏感性、特异性、准确度及阳性预测值分别为100％、97.4％、98.6％、90.9％.结论 ARFI技术可定量评价组织硬度,结合常规超声检查可提高乳腺恶性肿瘤诊断的敏感度和准确度.%Objective The shear wave velocity (SWV) detected by acoustic radiation force impulse (ARFI) technology is a quantitative assessment of the tissue stiffness property. SWV of normal mammary gland parenchyma and breast lesions was investigated using ARFI technology. The present study was conducted to investigate the value of SWV in the differential diagnosis of breast tumor of benign and malignancy. Methods The examination of the normal mammary gland parenchyma and the 146 lesions in 101 patients started with conventional ultrasound followed by ARFI technology. The results were compared and analysised to distinguish the benign and malignant tumors of breast. Results The mean shear wave velocity in the normal mammary gland parenchyma was (1. 63 ± 0. 47) m/s. The mean shear wave velocity of the benign lesions and the malignant lesions were (2. 38 ± 0. 55) m/s and (7. 34±1. 76) m/s. There was significant difference of the SWV between benign and malignant lesions. The sensitivity,specificity,accuracy and positive predictive value of ARFI were 100% ,97. 4% ,98. 6% ,90. 9% ,respectively. The sensitivity,specificity accuracy and positive predictive value of ARFI combined with BIRADS were 100% ,97. 4% ,98. 6% ,90. 9% respectively. Conclusions ARFI provides quantitative elasticity measurements, which was a complement method to conventional ultrasound and the diagnostic sensitivity and accuracy of breast lesions could be potentially improved. It is thought to be a potentially premising ultrasound technique for the diagnosis of breast lesions.
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