| Objective:Through the observation of conventional ultrasound,blood flow resistance index of breast lesions and virtual touch tissue imaging and quantitative(VTIQ)to analysis the features of breast Ductal carcinoma in situ.To explore the value of breast lesions,increased blood flow resistance index and the virtual touch tissue imaging(VTIQ)for the diagnosis of breast ductal carcinoma in situ.MethodsA total of 106 breast lesions during June 2015 to October 2016 underwent ultrasound examination and pathology confirmed.The breast lesions were first examined by conventional ultrasound.The size,boundary,internal echogenicity,and blood supply were observed and recorded。The lesions were selected to meet any of the following items were included in the study:1.the lesion aspect ratio was greater than 1;2.the boundary of the lesions was unclear;3.the blood flow signal was found in the peripheral blood of lesions;4.the lesions were irregular in shape;5.moderate lesion size.The average shear wave velocity(SWV)value was obtained from multiple SWV measurements under the VTIQ speed mode.VTIQ velocity mode in the effective measurement area at the same time to carry out multiple sets of SWV data measurement(group 5-7),the average value of m/s.ROI sampling,according to the VTIQ two-dimensional shear wave elastic image in different colors,the ROI were placed in the lesions of the highest SWV region,the lowest area Peripheral and central area.All the conventional ultrasound images and VTIQ images are stored in the ultrasonic machine hard disk for further analysis.The pathological results were used as the gold standard to compare the difference of SWV between breast cancer and benign breast cancer,and to evaluate the diagnostic value of VTIQ and blood flow resistance index.ResultsAccording to the pathological results,37 cases of breast ductal carcinoma in situ.,32 cases of intraductal papilloma,31 cases of breast hyperplasia and adenoma formation,6 cases of benign phyllodes tumor.106 cases of breast lesions,there were 82 cases of blood flow signal,of which blood supply for the edge of the type in the presence of a total of 63 cases,perforating type in the presence of a total of 19 cases.There were 31 cases of intraductal carcinoma,and the other 32 cases were benign lesions.There were 4 cases of intraductal carcinoma,and the other 15 cases were benign lesions.The blood flow resistance index of borderline ductal carcinoma in situ is(0.704 + 0.05),peripheral blood flow resistance index for benign breast lesions(0.616 + 0.056),t =-5.08,P value is less than 0.01,the difference was statistically significant.The number of cases of perforating syndrome is too small,and it is lack of statistical significance.The average SWV of breast intraductal carcinoma group was(3.98±1.27),the average SWV value of benign breast disease group(2.80±0.92),t = 10.33,P<0.01,clinically meaningful differences,ROC curve,ROC curve shows:SWV diagnosis of breast masses measured by VTIQ technology intraductal carcinoma and benign lesion of the threshold is 4.09m/s,the area under the curve was 0.827(95%CI:0.771～0.882,P<0.001).The ROC curve showed that the VTIQ differential diagnosis of benign and malignant breast tumors of the sensitivity,specificity,accuracy,positive predictive value,negative predictive value and Youden index were 87.9%,83%,75%,78.5%,86.7%,0.61.ConclusionsThe resistance index of blood flow in the marginal zone of the lesion has some guiding value in the differential diagnosis of breast ductal carcinoma and benign lesions.For the diagnosis of ductal carcinoma in situ,VTIQ shear wave technique has a certain reference value and can be used for the detection of ductal carcinoma in situ.Therefore,when the two-dimensional ultrasound can not distinguish between benign and malignant tumors,the use of VTIQ technology and the measurement of blood flow resistance index in the marginal zone of the lesion can provide reference value for the diagnosis. |
PDF Full Text Request