Jayaraman Jayapriya, Indiran Venkatraman, Kannan Kanakaraj, Maduraimuthu Prabakaran
Radiodiagnosis, Sree Balaji Medical College and Hospital.
Sree Balaji Medical College and Hospital.
Cureus. 2017 Jun 1;9(6):e1301. doi: 10.7759/cureus.1301.
Elastography is a promising way to assess tissue differences regarding stiffness or elasticity, which has been historically assessed manually by palpation. Combined with conventional imaging modalities, shear wave elastography can potentially evaluate the stiffness of a breast lesion and consequently help detect malignant breast tumor from benign ones. The aim of this study was to evaluate the diagnostic role of shear wave elastography in breast lesions in the Indian population.
Fifty patients presenting with breast lesions were included in the study. All the patients were subjected to B-mode ultrasound and elastography using shear wave with Virtual Touch Imaging (VTI) (Siemens Medical Solutions USA, Inc., PA, USA) and Virtual Touch Quantification (VTQ) (Siemens Medical Solutions USA, Inc., PA, USA) and the obtained data was analyzed using an appropriate statistical test (independent samples t-test).
In our study group of 50 patients, 34 were benign and 16 were malignant. VTI showed a sensitivity of 97% and a specificity of 93% with a positive predictive value (PPV) of 97% for benign lesions. VTI showed a sensitivity of 87.5 % and a specificity of 100% with a PPV of 100% for malignant lesions. VTQ showed a sensitivity of 71.4% and a specificity of 100% with a PPV of 100% for benign lesions. VTQ showed a sensitivity of 100% and a specificity of 100% with a PPV of 76.6% for malignant lesions.
VTI was more reliable as a diagnostic tool compared to VTQ in benign lesions and both are equally reliable in identifying malignant lesions. Acoustic radiation force impulse (ARFI) plays a significant role as an adjuvant diagnostic tool to B-mode imaging for assessing breast lesions.
弹性成像技术是一种评估组织硬度或弹性差异的有前景的方法，过去一直通过触诊进行手动评估。结合传统成像方式，剪切波弹性成像技术有可能评估乳腺病变的硬度，从而有助于区分乳腺良性肿瘤和恶性肿瘤。本研究旨在评估剪切波弹性成像技术在印度人群乳腺病变中的诊断作用。
本研究纳入了50例患有乳腺病变的患者。所有患者均接受了B超检查，并使用配备虚拟触诊成像（VTI）（美国宾夕法尼亚州西门子医疗解决方案公司）和虚拟触诊定量（VTQ）（美国宾夕法尼亚州西门子医疗解决方案公司）的剪切波进行弹性成像检查，所得数据采用适当的统计检验（独立样本t检验）进行分析。
在我们的50例患者研究组中，34例为良性病变，16例为恶性病变。VTI对良性病变的敏感性为97%，特异性为93%，阳性预测值（PPV）为97%。VTI对恶性病变的敏感性为87.5%，特异性为100%，PPV为100%。VTQ对良性病变的敏感性为71.4%，特异性为100%，PPV为100%。VTQ对恶性病变的敏感性为100%，特异性为100%，PPV为76.6%。
在良性病变中，与VTQ相比，VTI作为诊断工具更可靠，而在识别恶性病变方面两者同样可靠。声辐射力脉冲（ARFI）作为B超成像评估乳腺病变的辅助诊断工具发挥着重要作用。
