两种声触诊组织定量技术鉴别乳腺包块良恶性的价值

doi:10.6040/j.issn.1671-7554.0.2017.1184

摘要/Abstract

摘要： 目的比较声触诊组织定量(VTQ)与声触诊组织量化(VTIQ)技术在乳腺包块良恶性鉴别诊断中的应用价值。方法选取山东大学齐鲁医院经术后病理证实的102例患者,共136个乳腺包块,行常规超声、VTQ和VTIQ检查,VTQ技术测量剪切波速度SWV_VTQ,VTIQ技术测量SWV的最大值SWV_max、最小值SWV_min、平均值SWV_mean。分别绘制受试者工作特征(ROC)曲线,比较曲线下面积(AUC)。以病理结果为金标准,分析SWV_VTQ、SWV_max、SWV_min、SWV_mean 4种测值分别用于鉴别诊断乳腺包块良恶性的敏感度、特异度、准确性、阳性预测值和阴性预测值。结果术后病理显示所有包块中,恶性包块94个,良性包块42个。二者的SWV_VTQ、SWV_max、SWV_min、SWV_mean测值均有差异(P<0.05);ROC曲线下面积比较,以SWV_mean诊断效能最佳(AUC=0.91);SWV_max诊断乳腺良恶性包块的敏感性最高(83.0%),而SWV_mean的诊断特异性最高(95.2%)。结论 VTQ和VTIQ弹性成像技术都可较好地应用于乳腺包块良恶性的鉴别诊断,其中以VTIQ 测量SWV_mean的诊断效能更佳。

关键词: 超声, 乳腺包块, 弹性成像技术, 声触诊组织定量, 声触诊组织量化

Abstract: Objective To compare the diagnostic value of two elastography techniques, virtual touch tissue quantification(VTQ)and virtual touch tissue imaging quantification(VTIQ), in differentiating benign breast masses from malignant ones. Methods A total of 102 patients in Qilu Hospital of Shandong University with 136 nodules were evaluated by conventional ultrasound, VTQ and VTIQ. Shear wave velocities(SWVs)of breast masses were measured by VTQ and VTIQ. The receiver operating characteristic(ROC)curves of VTQ SWV_VTQ and VTIQ SWV_max, SWV_min and SWV_mean were used to assess the value on differentiating benign and malignant masses. Areas under the curve(AUC)of the four groups were compared. The sensitivity, specificity, accuracy, positive predictive value(PPV)and negative predictive value(NPV)of the four measurements were respectively calculated. Results Pathologically, 94 breast masses were benign and 42 were malignant. Significant differences of SWV_max, SWV_min, SWV_mean and SWV_VTQ between 山东大学学报 (医学版)56卷4期 -李良,等.两种声触诊组织定量技术鉴别乳腺包块良恶性的价值 \=-benign and malignant groups were found(P<0.05). Of all these four measurements, the SWV_mean was the most valuable measurement(AUC=0.91), the diagnostic sensitivity of SWV_max was the highest(83.0%), and the diagnostic specificity of SWV_mean was the strongest(95.2%). Conclusion VTQ and VTIQ have good diagnostic performance on distinguishing malignant breast masses from benign ones. VTIQ SWV_mean shows better diagnostic performance than SWV_VTQ.

Key words: Ultrasound, Breast masses, Elasticity imaging techniques, Virtual touch tissue quantification, Virtual touch tissue imaging quantification

中图分类号:

R445.1

李良,葛娜,孙霄,李杰,朱江,李忠良. 两种声触诊组织定量技术鉴别乳腺包块良恶性的价值[J]. 山东大学学报 (医学版), 2018, 56(4): 70-75.

LI Liang, GE Na, SUN Xiao, LI Jie, ZHU Jiang, LI Zhongliang. Value of VTQ and VTIQ on differentation of benign and malignant breast masses[J]. Journal of Shandong University (Health Sciences), 2018, 56(4): 70-75.

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