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目的应用声触诊组织量化技术(virtual touch tissue quantification,VTQ)对BI-RADS 4级乳腺病变进行定量研究,探讨该技术在BI-RADS 4级乳腺良恶性病变中的诊断价值。方法应用VTQ技术对81例患者98个经常规超声诊断为BI-RADS 4级乳腺病灶进行检查,测得病灶内部及对侧同层腺体的剪切波速度(shear wave velocity,SWV),以病理诊断为金标准,构建受试者工作特征曲线(receiver operating characteristic curve,ROC),找出病灶内部SWV值及病灶内部与对侧同层腺体SWV比值诊断BI-RADS 4级乳腺恶性病变的最佳截点。结果 BI-RADS 4级乳腺恶性病灶SWV值大于良性病灶[(7.01±3.15)m/s vs(2.44±1.05)m/s,P<0.001]]。以SWV值4.08 m/s作为诊断BI-RADS 4级乳腺恶性病灶的最佳截点,灵敏度为75.0%,特异度为98.4%,准确度为89.8%。BI-RADS 4级乳腺恶性病灶内部与对侧同层腺体的SWV比值大于良性病灶的SWV比值[(3.27±1.43)vs(1.55±0.68),P<0.001),以SWV比值2.67为截点诊断BIRADS 4级乳腺恶性肿块的灵敏度为72.2%,特异度为95.2%,准确度为86.7%。结论 VTQ技术对BIRADS 4级乳腺病变良恶性诊断有较高的应用价值。
Objective To evaluate the diagnostic value of BI-RADS grade 4 breast lesions by virtual touch tissue quantification (VTQ) and to evaluate the diagnostic value of this technique in benign and malignant lesions of BI-RADS grade 4. Methods Eighty-eight patients with BI-RADS grade 4 breast lesions diagnosed by conventional ultrasonography were examined by VTQ technique. The shear wave velocity (SWV) of the gland in the lesion and the contralateral side was measured with Pathological diagnosis as the gold standard, constructing receiver operating characteristic curve (ROC), finding the SWV value in the lesion and the ratio of the SWV in the lesion and contralateral stratified gland in the diagnosis of grade 4 breast cancer The best cut-off point. Results The SWV of grade 4 breast cancer was higher than that of benign lesion in BI-RADS grade 4 [(7.01 ± 3.15) m / s vs (2.44 ± 1.05) m / s, P <0.001]. The SWV value of 4.08 m / s was the best cut-off point for diagnosing grade 4 breast cancer. The sensitivity was 75.0%, the specificity was 98.4% and the accuracy was 89.8%. The SWV ratio in the BI-RADS grade 4 breast malignant lesion was significantly higher than that in the benign lesion (3.27 ± 1.43 vs 1.55 ± 0.68, P <0.001), and the SWV ratio was 2.67 The sensitivity of BIRADS grade 4 breast malignancies was 72.2%, the specificity was 95.2% and the accuracy was 86.7%. Conclusion The VTQ technique is of great value in the diagnosis of benign and malignant breast lesions of BIRADS grade 4.