| Objective: To use ordinary two-dimensional Doppler (2D) ultrasonic imaging, color Doppler flow imaging (CDFI) and acoustic palpate diagnostic techniques in analyzing the features of benign and malignant tumors in the breast. To explore the values of elastic imaging (EI), ARFI (acoustic radiation force impulse) in the way of differential diagnosis of benign or malignant breast tumors.Analysing the related factors of the hardness in breast carcinoma which compared with histopathology.Material and methods: Between November 2010 and march 2011,all the patients enrolled in the research who went to our hospital for physical examinations received the surgery. And every lesion thereafter underwent pathological assessments. There are 113 patients with the total numbers of 119 lesions, including 89 benign lesions, 30 malignant lesions. EI and ARFI was performed using a ACUSON S 2000 scanner (Siemens company) with a 9L4 probe (4～9 MHz) which equipped with the software of EI and ARFI. Patients may take lateral position or supine position when the were examined. Every breast lesions were performed by 2D ultrasonic imaging firstly ,Which contained the size,shape,boundary and echo inside in the tumors. Then, started the color Doppler flow imaging mode to observe the blood flow condition of the breast tumors of ,using Doppler ultrasound technology measure the peak flow velocity, acceleration and resistance index which inside the breast tumor and surrounding the tumors .Use the EI mode of acoustic palpate diagnostic techniques ,calculate the acreage ratio of tumorous between 2D ultrasonic imaging and EI , then into the VTI model of ARFI, measure the acreage ratio of tumorous between 2D ultrasonic imaging and VTI . Finally into the VTQ mode in order to measure the transverse shear wave velocity of tumor. When measurement under the mode of EI and ARFI, ask the patient to hold his breath, and we get the VTQ by measuring both the interior and surrounding of the breast tumor which has homogeneous echo under the mode of VTQ , each part measure three or more times at least then use the average value as the ultimate VTQ. Analysis of all lesions by two doctor with highly experienced in the diagnosis of breast disease who has worked more than 10 years, and they don't know the pathology when they analyzing the lesions , if there is a dispute , a third doctor will judge it. All cases compare the pathologic results.Results: The specificity,the sensibility and the accuracy of the ARFI in diagnosis of breast tumorous is 97.8% ,96.7% and 97.5%. The specificity,the sensibility and the accuracy of 2D ultrasonic imaging in diagnosis of breast tumorous is 93.3% ,66.7% and 86.6%. The specificity, the sensibility and the accuracy of the semi quantitative methods which put forward by Adler of CDFI grade in diagnosis of breast tumorous is 83.2% , 70% and 79.8%..The interior average value of VTQ of benign tumors is 2.35±0.05m/s,the average value of VTQ surround the benign tumors is 1.59±0.23 m/s. The interior average value of VTQ of malignancy is 4.97±0.27m/s, the average value of VTQ surround the malignancy is 3.05±0.29 m/s.The VTQ value has significant difference between benign and malignant tumors(P<0.01),the VTQ value surround the tumor has significant difference between benign and malignant tumors(P<0.05).The VTI area ratio has significant difference between benign and malignant tumors(P<0.05),the area ratio of benign tumor <1.2, but the area ratio of malignant tumor >1.5.The EI area ratio has significant difference between benign and malignant tumors(P<0.05),the area ratio of benign tumor <1.5, but the area ratio of malignant tumor >1.8.Conclusion: The ARFI has a high specificity in differentiating the benign or malignant tumors of breast, combine with conventional ultrasound can significantly improve the diagnostic rate of the breast cancer.ARFI has a high value in judging the hardness of breast tumor, and has relativity with the pathology. |
