文章摘要
李月兴,胡秋根,黄伟俊,叶洁仪,袁雅婷,潘凤涛.声触诊组织定量成像联合声诺维超声造影对乳腺BI-RADS 4类结节的鉴别诊断价值[J].,2021,(13):2484-2488
声触诊组织定量成像联合声诺维超声造影对乳腺BI-RADS 4类结节的鉴别诊断价值
The Differential Diagnosis Value of Virtual Touch Tissue Imaging Quantification Combined with Sonoway Contrast-enhanced Ultrasound for Breast BI-RADS Type 4 Nodules
投稿时间:2020-11-24  修订日期:2020-12-18
DOI:10.13241/j.cnki.pmb.2021.13.017
中文关键词: 乳腺结节  声触诊组织定量成像  BI-RADS 4类  声诺维超声造影  诊断
英文关键词: Breast nodules  Virtual touch tissue imaging quantification  BI-RADS type 4  Sonoway contrast-enhanced ultrasound  Diagnosis
基金项目:广东省医学科研基金项目(A2016443)
作者单位E-mail
李月兴 南方医科大学研究生院 广东 广州 510515佛山市第一人民医院超声诊疗中心 广东 佛山 528000 liyuexing00@sina.com 
胡秋根 南方医科大学研究生院 广东 广州 510515南方医科大学顺德医院/佛山市顺德第一人民医院放射科 广东 佛山 528300  
黄伟俊 佛山市第一人民医院超声诊疗中心 广东 佛山 528000  
叶洁仪 佛山市第一人民医院超声诊疗中心 广东 佛山 528000  
袁雅婷 佛山市第一人民医院超声诊疗中心 广东 佛山 528000  
潘凤涛 佛山市第一人民医院乳腺肿瘤内科 广东 佛山 528000  
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中文摘要:
      摘要 目的:探讨声触诊组织定量成像(VTIQ)联合声诺维超声造影对乳腺BI-RADS 4类结节的鉴别诊断价值。方法:将我院2018年6月至2019年12月门诊及住院诊治的90例女性乳腺结节患者作为研究对象,利用VTIQ超声弹性成像技术,获取剪切波速度最大值(SWVmax)、剪切波速度最小值(SWVmin)、剪切波速度平均值(SWVmean),声诺维超声造影评估病灶回声、形态、血管充盈情况。以手术病理或超声引导穿刺活检病理结果作为金标准,分析VTIQ超声弹性成像联合声诺维超声造影对乳腺BI-RADS 4类结节的鉴别诊断价值。结果:90例患者(90个乳腺结节)中,经手术病理检查62例,经超声引导穿刺活检28例,其中良性结节48例,恶性结节42例。乳腺BI-RADS 4类良性及恶性结节的SWVmax、SWVmin及SWVmean比较有统计学差异(P<0.05);以SWVmax≥3.83 m/s作为截断点,鉴别诊断乳腺BI-RADS 4类良恶性结节的曲线下面积(AUC)、敏感度、特异度分别为0.875、83.33%、91.67%,均高于SWVmin及SWVmean。SWVmax、声诺维超声造影与联合诊断的准确率比较无统计学差异(P>0.05)。SWVmax联合声诺维超声造影检查在鉴别诊断乳腺BI-RADS 4类良恶性结节的AUC、敏感度、特异度分别为0.914、95.24%、87.50%,诊断效能最佳。结论:声诺维超声造影、VTIQ超声弹性成像在乳腺BI-RADS 4类结节鉴别诊断中有一定的价值,VTIQ超声弹性成像的SWVmax参数诊断效能优于SWVmin及SWVmean,VTIQ超声弹性成像联合声诺维超声造影可提升乳腺BI-RADS 4类结节鉴别诊断效能。
英文摘要:
      ABSTRACT Objective: To explore the differential diagnosis value of virtual touch tissue imaging quantification (VTIQ) combined with sonoway contrast-enhanced ultrasound for breast BI-RADS type 4 nodules. Methods: 90 female patients with breast nodules who were treated in outpatient and inpatient treatment in our hospital from June 2018 to December 2019 were selected as study subjects. VTIQ ultrasonic elastic imaging technology was used to obtain the maximum shear wave velocity(SWVmax), minimum shear wave velocity (SWVmin) and average shear wave velocity (SWVmean) parameters. Sonoway contrast-enhanced ultrasound was used to evaluate the echogenicity of lesions, morphology and vascular filling. The pathological results of surgical pathology or ultrasound-guided puncture biopsy were taken as the gold standard, the differential diagnostic value of VTIQ ultrasonic elastic imaging technology combined sonoway contrast-enhanced ultrasoun for breast BI-RADS type 4 nodules were analyzed. Results: Among the 90 patients (90 breast nodules), 62 cases underwent surgical pathological examination, and 28 cases underwent ultrasound-guided puncture biopsy, including 48 cases of benign nodules and 42 cases of malignant nodules. The SWVmax, SWVmin and SWVmean of breast BI-RADS type 4 benign and malignant nodules were statistically different(P<0.05). With SWVmax≥3.83 m/s as the cut-off point, the area under the curve (AUC), sensitivity, specificity of differentiating and diagnosing benign and malignant nodules of breast BI-RADS type 4 nodules were 0.875, 83.33%, 91.67% respectively, which were all higher than SWVmin and SWVmean. There was no statistically significant difference among the accuracy of SWVmax, sonoway contrast-enhanced ultrasound and combined diagnosis(P>0.05). The AUC, sensitivity, specificity of SWVmax combined sonoway contrast-enhanced ultrasound in differentiating and diagnosing benign and malignant nodules of breast BI-RADS type 4 nodules were 0.914, 95.24%, 87.50% respectively, the diagnosis efficiency was best. Conclusion: Sonoway contrast-enhanced ultrasound and VTIQ ultrasonic elastic imaging technology are of certain value in the differential diagnosis of breast BI-RADS type 4 nodules. The diagnostic efficiency of SWVmax parameter of VTIQ ultrasonic elastic imaging technology is superior to SWVmin and SWVmean. VTIQ ultrasonic elastic imaging technology combined with sonoway contrast-enhanced ultrasound can improve the differential diagnosis efficiency of breast BI-RADS type 4 nodules.
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