弹性应变率比值法与声触诊组织量化技术对乳腺肿块的诊断价值

doi:10.6040/j.issn.1671-7554.0.2018.1397

摘要/Abstract

摘要： 目的比较弹性应变率比值法与声触诊组织量化(VTQ)技术对乳腺肿块的诊断价值。方法经手术病理证实的49例女性乳腺疾病患者共计52个乳腺肿块进行压迫式弹性成像和VTQ检查,分别测量肿块与周围正常腺体的应变率比值、肿块内部的剪切波传播速度。构建受试者工作特征(ROC)曲线,分析两种超声弹性成像方法对乳腺肿块的诊断价值,并采用Z检验进行比较。结果弹性应变率比值法鉴别乳腺良恶性病变的曲线下面积为0.919,最优诊断界点为0.499,灵敏度、特异度、阳性预测值、阴性预测值、准确率分别为93.6%、72.0%、78.8%、94.7%、84.6%;VTQ技术鉴别诊断乳腺良恶性病变的曲线下面积为0.796,最优诊断界点为2.90 m/s,灵敏度、特异度、阳性预测值、阴性预测值、准确率分别为68.0%、92.6%、89.5%、75.8%、80.8%。两种超声弹性成像方法的ROC曲线下面积比较差异无统计学意义(Z=1.580,P=0.057)。两者联合鉴别诊断乳腺良恶性病变,灵敏度为84.0%,特异度为88.9%,PPV为87.5%,NPV为85.7%,准确率为86.5%。结论弹性应变率比值法与VTQ技术能够(半)定量评价乳腺肿块的硬度,两者对乳腺肿块的鉴别诊断价值相近。弹性应变率比值法的灵敏度高于VTQ技术,而特异度却低于VTQ技术。两者联合应用可提高超声鉴别诊断乳腺良恶性病变的灵敏度、特异度和准确率。

关键词: 弹性成像, 应变率, 声触诊组织量化, 乳腺肿瘤, 超声检查

Abstract: Objective To compare the diagnostic performances of strain ratio of compression elastography and virtual touch tissue quantification(VTQ)in the differentiation of benign and malignant breast lesions. Methods A total of 49 female patients with 52 breast lesions were enrolled in this study. Both compression elastography and VTQ were performed, and SR and shear wave velocity were measured. Receiver operating characteristic(ROC)curves were used to analyze the diagnostic performances and Z tests were used to compare the area under the curve. Results For the SR method, the AUC, optimal cutoff value, sensitivity, specificity, positive predictive value, negative predictive value(NPV)and accuracy was 0.919, 0.499, 93.6%, 72.0%, 78.8%, 94.7%, and 84.6%, respectively. For the VTQ method, the AUC, optimal cutoff value, sensitivity, specificity, PPV, NPV and accuracy was 0.796, 2.90 m/s, 68.0%, 山东大学学报 (医学版)57卷6期 -商蒙蒙,等.弹性应变率比值法与声触诊组织量化技术对乳腺肿块的诊断价值 \=-92.6%, 89.5%, 75.8% and 80.8%, respectively. There was no significant difference in AUC between the two methods (Z=1.580, P=0.057). When compression elastography and VTQ were used in combination, the sensitivity, specificity, PPV, NPV and accuracy was 84.0%, 88.9%, 87.5%, 85.7% and 86.5%, respectively. Conclusion Both SR and VTQ are helpful in the(semi-)quantitative evaluation of the stiffness of breast lesions. Their diagnostic performances are similar. The SR method shows higher sensitivity but lower specificity than VTQ. The combination of compression elastography and VTQ can significantly improve the diagnostic performance of ultrasound to differentiate benign and malignant breast lesions.

Key words: Elastography, Strain ratio, Virtual touch tissue quantification, Breast lesion, Ultrasonography

中图分类号:

R445.1

商蒙蒙,张岩,程琳,孙霄,时丹丹,闵香,李杰. 弹性应变率比值法与声触诊组织量化技术对乳腺肿块的诊断价值[J]. 山东大学学报 (医学版), 2019, 57(6): 94-99.

SHANG Mengmeng, ZHANG Yan, CHENG Lin, SUN Xiao, SHI Dandan, MIN Xiang, LI Jie. Value of strain ratio of compression elastography and virtual touch tissue quantification in the diagnosis of breast lesions[J]. Journal of Shandong University (Health Sciences), 2019, 57(6): 94-99.

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