Zhang Lu, Zhou Ping, Deng Jin, Tian Shuangming, Qian Ying, Wu Xiaomin, Ma Shuhua, Li Jiale
Department of Ultrasound, Th ird Xiangya Hospital, Central South University, Changsha 410013, China.
Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2014 Dec;39(12):1246-52. doi: 10.11817/j.issn.1672-7347.2014.12.005.
To evaluate the diagnostic performance of conventional ultrasound, compression elastography (CE) and acoustic radiation force impulse imaging (ARFI) in differential diagnosis of benign and malignant breast tumors.
A total of 98 patients with liver lesions were included in the study. The images of conventional ultrasound, CE and the values of virtual touch tissue quantification (VTQ) of breast lesions were obtained. The diagnostic performance of conventional ultrasound, CE and ARFI were assessed by using pathology as the gold standard, and then evaluate the diagnosis efficiency of these three approaches in differential diagnosing benign and malignant breast tumors.
The specificity, sensitivity and accuracy in the diagnosis of malignant breast tumors for conventional ultrasound were 80.0%, 81.1% and 81.7%, respectively, whereas for CE elastic score were 85.7%, 86.7% and 86.3%, respectively. With a cutoff value of 3.71 for the SR, the sensitivity, specificity, accuracy in diagnosis of malignant breast tumors were 97.1%, 83.3% and 88.4%, respectively. With a cutoff value of 3.78 m/s for VTQ, the sensitivity, specificity, accuracy in diagnosis of malignant breast tumors were 94.3%, 91.7% and 92.6%, respectively. The difference in diagnosis efficiency among ARFI, CE and conventional ultrasound in differential diagnosis of benign and malignant breast tumors was significant (P< 0.05).
Conventional ultrasound, CE and ARFI are all useful for the differential diagnosis of benign and malignant breast tumors. But the diagnosis efficiency of ARFI is superior to CE and conventional ultrasound. The three approaches can help each other in differential diagnosis of benign and malignant breast tumors.
评估常规超声、弹性成像（CE）和声辐射力脉冲成像（ARFI）在乳腺良恶性肿瘤鉴别诊断中的诊断性能。
本研究共纳入98例乳腺病变患者。获取乳腺病变的常规超声、CE图像及虚拟触诊组织定量（VTQ）值。以病理结果为金标准，评估常规超声、CE及ARFI的诊断性能，进而评价这三种方法在乳腺良恶性肿瘤鉴别诊断中的诊断效率。
常规超声诊断乳腺恶性肿瘤的特异性、敏感性和准确性分别为80.0%、81.1%和81.7%，而CE弹性评分的特异性、敏感性和准确性分别为85.7%、86.7%和86.3%。以剪切波弹性成像（SR）值3.71为截断值时，诊断乳腺恶性肿瘤的敏感性、特异性和准确性分别为97.1%、83.3%和88.4%。以VTQ值3.78 m/s为截断值时，诊断乳腺恶性肿瘤的敏感性、特异性和准确性分别为94.3%、91.7%和92.6%。ARFI、CE和常规超声在乳腺良恶性肿瘤鉴别诊断中的诊断效率差异有统计学意义（P<0.05）。
常规超声、CE和ARFI均有助于乳腺良恶性肿瘤的鉴别诊断。但ARFI的诊断效率优于CE和常规超声。这三种方法在乳腺良恶性肿瘤鉴别诊断中可相互补充。
