Preliminary Research Of Acoustic Radiation Force Impulse (ARFI) Imaging To Mammary Gland Disease For Quantitative Analysis

PurposeTo use ordinary two-dimensional Doppler ultrasonic imaging, color Doppler flow imaging (CDFI) and acoustic radiation force impulse (ARFI) techniques in analyzing the features of benign and malignant tumors in the breast. To explore the values of ARFI in the way of differential diagnosis of benign or malignant breast tumors. To measure the VTQ values of normal mammary gland, and analyzes the breast density of the different physiological stage.MethodsBetween February and August in2012, all the patients enrolled in the research who went to our hospital for physical examinations. There arelll patients with the total numbers of125lesions which thereafter underwent pathological assessments,100women without any tumor under the X-ray. Every breast lesions were performed by2D ultrasonic imaging mode and the color Doppler flow imaging mode to observe the all kind of features, and assessed by BI-RADS classification and Alder semi-quantitative method classification; then into the VTI model of ARFI, measure the acreage ratio of tumorous between2D ultrasonic imaging and VTI and the diameter ratio of tumorous between2D ultrasonic imaging; Finally into the VTQ mode in order to measure the transverse shear wave velocity of tumor and the edge of the tumor.The100normal mammary glands were tested the value of VTQ in thecentral mammary gland at12o’clock2cm far away from the nipple. All data processed software by SPSS-18.0, using t test and Bonferroni test, P<0.05was consider statistically significant. Draw the ROC curves of the VTQ value.ResultsThe specificity, the sensibility, the accuracy, the negative predictive value, and the positive predictive value of CDFI classification in diagnosis of breast tumorous is66.0%,61.5%、63.2%、75.0%、50.8%; The specificity, the sensibility, the accuracy,the negative predictive value, and the positive predictive value of BI-RADS classification in diagnosis of breast tumorous is93.6%、76.9%%、83.2%、95.2%、71.0%;The VTI diameter radio and area ratio have significant difference between benign and malignant tumors(P<0.05). The interior average value of VTQ of benign tumors is1.91±0.92m/s, the interior average value of VTQ of malignancy is6.19±3.13m/s.The VTQ value has significant difference between benign and malignant tumors(P<0.01). The best critical point to diagnosis the benign and malignant is2.27m/s, the AUC is0.923,the specificity, the sensibility is83.0%、86.8%. The VTQ value surround the tumor has significant difference between benign and malignant tumors (P<0.01),The best critical point isl.31m/s, the AUC is0.744, the specificity and the sensibility is74.5%,72.4%. The value of VTQ of the mammary gland is different from the glandular structure density under the X-ray(P<0.05). The values of VTQ of bilateral mammary gland in sexual maturation period is greater than old age (P<0.05).ConclusionThe ARFI has high specificity, sensitivity and accuracy in differentiating the benign or malignant tumors of breast. The VTI can help to identify the benign and malignant breast in qualitative and semi quantitative ways; and help to determine the infiltrating range of malignant tumors. VTQ has a high value in judging the hardness of breast tumor, provide a update more valuable method for the differential diagnosis of benign and malignant tumor; meanwhile VTQ can help to determine the density of mammary glands quantitatively, and provides a new indicator for screening high-risk groups and monitoring the key objects.