目的探讨声触诊组织量化技术(VTQ)在诊断乳腺肿瘤的良恶性方面的应用价值。方法 129例接受超声检查的乳腺肿块患者,共129个肿块,对VTQ诊断结果与术后病理结果进行比较,分析差异。结果 129例乳腺病灶,病理证实良性70例,其中纤维腺瘤57例,腺病13例;恶性59例,其中浸润性导管癌53例,浸润性小叶癌2例,髓样癌3例,导管原位癌1例。良性病灶VTQ平均值为(3.32±1.92)m/s,恶性病灶VTQ平均值为(5.96±2.79)m/s,比较差异有统计学意义(P〈0.05)。受试者工作特征曲线(ROC)曲线下面积为0.980。以剪切波速度(SWV)值3.97 m/s作为乳腺恶性结节的截断值,VTQ值〉3.97 m/s为恶性,VTQ值≤3.97 m/s为良性,声脉冲辐射力成像技术(ARFI)鉴别乳腺良恶性结节的敏感性为86.8%,特异性为84.7%,约登指数为0.715。结论声触诊组织量化技术在鉴别诊断乳腺肿瘤的良恶性方面具有较高的应用价值。
Objective To investigate application value of virtual touch tissue quantification(VTQ) in diagnosis of benign and malignant breast tumor. Methods There were 129 patients 129 with breast tumors under ultrasound examination. Comparison and analysis was made on VTQ diagnosis and postoperative pathological examination. Results Among the 129 breast lesions, there were 70 benign cases by pathological verification, as 57 cases with fibroadenoma, 13 cases with adenopathy, and 59 malignant cases, as 53 cases with invasive ductal carcinoma, 2 cases with invasive lobular carcinoma, 3 cases with medullary carcinoma, and 1 case with ductal carcinoma in situ. Average VTQ value was(3.32±1.92) m/s in benign lesion and(5.96±2.79) m/s in malignant lesion. Their difference had statistical significance(P〈0.05). Receiver operating characteristic(ROC) area under curve was 0.980. 3.97 m/s and shear wave velocity(SWV) was taken as cutoff value for malignant breast nodule, therefore, VTQ 〉3.97 m/s showed malignant, and VTQ ≤ 3.97 m/s showed benign. Acoustic radiation force impulse(ARFI) in identification of benign and malignant had sensibility as 86.8%, specificity as 84.7%, and Youden index as 0.715. Conclusion VTQ contains high application value in identification and diagnosis of benign and malignant breast tumor.