Wang Lin, Wan Cai-Feng, Du Jing, Li Feng-Hua
Department of Ultrasound, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.
J Ultrasound Med. 2018 Oct;37(10):2405-2412. doi: 10.1002/jum.14599. Epub 2018 Apr 15.
The purpose of this study was to evaluate the application of a new elastographic technique, acoustic radiation force impulse (ARFI) imaging, and its diagnostic performance for characterizing breast lesions.
One hundred consecutive female patients with 126 breast lesions were enrolled in our study. After routine breast ultrasound examinations, the patients underwent ARFI elasticity imaging. Virtual Touch tissue imaging (VTI) and Virtual Touch tissue quantification (Siemens Medical Solutions, Mountain View, CA) were used to qualitatively and quantitatively analyze the elasticity and hardness of tumors. A receiver operating characteristic curve analysis was performed to evaluate the diagnostic performance of ARFI for discrimination between benign and malignant breast lesions.
Pathologic analysis revealed 40 lesions in the malignant group and 86 lesions in the benign group. Different VTI patterns were observed in benign and malignant breast lesions. Eighty lesions (93.0%) of benign group had pattern 1, 2, or 3, whereas all pattern 4b lesions (n = 20 [50.0%]) were malignant. Regarding the quantitative analysis, the mean VTI-to-B-mode area ratio, internal shear wave velocity, and marginal shear wave velocity of benign lesions were statistically significantly lower than those of malignant lesions (all P < .001). The cutoff point for a scoring system constructed to evaluate the diagnostic performance of ARFI was estimated to be between 3 and 4 points for malignancy, with sensitivity of 77.5%, specificity of 96.5%, accuracy of 90.5%, and an area under the curve of 0.933.
The application of ARFI technology has shown promising results by noninvasively providing substantial complementary information and could potentially serve as an effective diagnostic tool for differentiation between benign and malignant breast lesions.
本研究旨在评估一种新的弹性成像技术——声辐射力脉冲（ARFI）成像的应用及其对乳腺病变的诊断性能。
100例连续的患有126个乳腺病变的女性患者纳入本研究。在进行常规乳腺超声检查后，患者接受ARFI弹性成像检查。使用虚拟触诊组织成像（VTI）和虚拟触诊组织定量分析（西门子医疗解决方案公司，加利福尼亚州山景城）对肿瘤的弹性和硬度进行定性和定量分析。进行受试者操作特征曲线分析以评估ARFI对乳腺良恶性病变鉴别的诊断性能。
病理分析显示恶性组有40个病变，良性组有86个病变。在乳腺良恶性病变中观察到不同的VTI模式。良性组80个病变（93.0%）为1、2或3型，而所有4b型病变（n = 20 [50.0%]）均为恶性。在定量分析方面，良性病变的平均VTI与B模式面积比、内部剪切波速度和边缘剪切波速度在统计学上显著低于恶性病变（所有P <.001）。为评估ARFI诊断性能构建的评分系统的恶性肿瘤临界值估计在3至4分之间，敏感性为77.5%，特异性为96.5%，准确性为90.5%，曲线下面积为0.933。
ARFI技术的应用通过无创提供大量补充信息显示出有前景的结果，并有可能作为鉴别乳腺良恶性病变的有效诊断工具。
