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目的评估声脉冲辐射力(acoustic radiation force impulse,ARFI)弹性成像技术对乳腺实性病变良恶性鉴别诊断价值。方法对62例患者的62个乳腺实性病灶行ARFI声触诊组织成像(virtual touch tissue imaging,VTI)及声触诊组织定量(virtual touch tissue quantitfication,VTQ)两种技术检查。以VTI弹性分级≥IV级判断为恶性病灶,VTQ中计算病灶剪切波速度(shear wave velocity,SWV)平均值。结果根据受试者工作特征(receiver operating characteristic,ROC)曲线得出乳腺良恶性病灶SWV平均值的最佳诊断截断值为4.12 m/s,曲线下面积(area under curve,AUC)分别为0.793,其灵敏度、特异度、准确率分别为76.92%、88.89%、83.87%;以VTI弹性分级≥IV级判断乳腺病灶为恶性,其灵敏度、特异度、准确率分别为76.92%、86.11%、82.26%,联合VTI及VTQ诊断的灵敏度、特异度及准确率分别92.30%,94.44%,93.55%。结论 ARFI技术定性及定量评价乳腺病灶的良恶性,对良恶性鉴别有较高诊断价值,两者结合应用对乳腺实性病灶的鉴别有较大帮助。
Objective To evaluate the differential diagnosis of benign and malignant breast lesions by elastography with acoustic radiation force impulse (ARFI). Methods 62 cases of breast solid lesions in 62 patients were examined by ARFI virtual touch tissue imaging (VTI) and virtual touch tissue quantitation (VTQ). The VTI elastic grading ≥ IV was used to determine the malignant lesions, and the mean shear wave velocity (SWV) was calculated in the VTQ. Results According to receiver operating characteristic (ROC) curve, the best diagnostic cutoff value of average SWV of benign and malignant breast lesions was 4.12 m / s, area under curve (AUC) was 0.793, The sensitivity, specificity and accuracy were 76.92%, 88.89% and 83.87% respectively. The sensitivity, specificity and accuracy of the method were 76.92%, 86.11% and 82.26% The sensitivity, specificity and accuracy of the combined VTI and VTQ were 92.30%, 94.44% and 93.55% respectively. Conclusion The ARFI technique can qualitatively and quantitatively evaluate the benign and malignant features of breast lesions and has high diagnostic value in the differential diagnosis of benign and malignant diseases. The combination of the two can be of great help in the identification of solid breast lesions.