| Objective:1.To investigate the differential diagnosis application value of acoustic radiation force impulse imaging(ARFI), including virtual touch tissue imaging(VTI) and virtual touch tissue quantitative(VTQ) in benign and malignant breast tumors.2.The shear wave velocity(SWV) of breast tumors within the region average, construct the receiver operating characteristic curve(ROC) to obtain the optimal cut-off value of SWV, providing new observation index for diagnosis of benign and malignant breast tumors.3.To investigate the diagnostic value of the old version and the new version of breast imaging reporting and data system(BI-RADS) grading for the differential diagnosis of breast tumors.4.The diagnostic value of ARFI technology combined with the new version of BI-RADS classification in diagnosis of breast tumors.Materials and methods:This study was selected in November 2014~2015 in July in Wuxi Second People’s Hospital, 107 cases of female patients with breast tumor were found, a total of 123 lumps. All cases were confirmed by pathology after surgery or biopsy, including 76 benign masses and 47 malignant tumors. Ultrasonic diagnostic instrument: Acuson S2000 Siemens, with the acoustic radiation force impulse imaging technology. All tumors were observed in the two-dimensional ultrasound mode to observe the size, shape, internal echo, surrounding tissue, and then into the color Doppler to observe the blood flow of breast tumors and the surrounding area, and the resistance index of breast tumor was measured by using the spectrum Doppler ultrasound technique. After BI-RADS classification of tumor, VTI images of breast tumors were obtained by VTI technology, and the tumors were evaluated. SWV values of the tumors, the edge of the tumor and the surrounding normal mammary glands were measured by VTQ technology, and the average values were measured by 5 times.The statistical software was used to analyze the data. The diagnostic value of VTQ technology for breast tumor benign and malignant, P< 0.05 was statistically significant.Result:1.VTI score 1~3 score was judged to be benign, 4~5 score was malignant, the accuracy, sensitivity and specificity of the differential diagnosis of breast tumors were 87%(107/123), 85.11%(40/47), 88.16%(67/76), respectively. The interior average value of SWV of benign tumors was 2.66±0.99m/s,the average value of SWV surround the benign tumors was 2.55±0.78m/s,the average value of SWV of nomal breast tissue around the benign tumors was 1.92±0.48m/s.The interior average value of SWV of malignancy was 5.75±2.11m/s,the average value of SWV surround the malignancy was 4.43±1.78m/s, the average value of SWV of nomal breast tissue around the malignancy was 2.46±0.57m/s.The average value of SWV in the benign and malignant tumors was statistically different(P< 0.01).2.The pathological results for gold standard, in the inner region of the breast tumor SWV mean to build ROC, the area under the curve(AUC) was 0.911, Youden index maximum value was 0.809, the point corresponding to the best SWV diagnosis critical value was 3.795m/s. The diagnosis of breast tumor accuracy of 89.43%(110/123), sensitivity of 80.85%(38/47), specificity of 94.74%(72/76).3.The old BI-RADS classification of differential diagnosis of benign and malignant breast tumors and the accuracy of 79.67%(98/123), the sensitivity of 89.36%(42/47),specificity of 73.68%(56/76).The new BI-RADS classification of differential diagnosis of benign and malignant breast tumors and the accuracy of 86.99%(107/123), the sensitivity of 82.98%(39/47), specificity of 89.47%(68/76).There was a statistical difference between the accuracy and specificity of the new version of BI-RADS and the old version of BI-RADS(P < 0.05).4.ARFI(VTI+VTQ) technology combined with the new BI-RADS classification diagnostic criteria for the differential diagnosis of breast tumors benign and malignant accuracy, sensitivity were 89.43%, 91.49%, were higher than the single method, but the mutual two two comparisons were not statistically significant.Conclusion:1.As an effective complement to conventional ultrasound, ARFI technology has high clinical value in differential diagnosis of benign and malignant breast tumors. ARFI technology can objectively and quantitatively evaluate the hardness of the tumors. The VTI technology can be used to identify benign and malignant breast tumors. The average value of SWV in 3.795m/s is the boundary, which can distinguish benign and malignant breast tumors.2.The accuracy and specificity of the new BI-RADS classification of malignant breast tumors were higher than that of the old version of BI-RADS.3.ARFI technology combined with the new BI-RADS grade can improve the differential diagnosis of benign and malignant breast lesions. |
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