| Objective: To explore soft tissue tumors in ARFI(Acoustic Radiation Force Impulse),DWI(Diffusion Weighted Imaging)combined with conventional US(Ultrasound,Ultrasound)and Conventional MRI(Magnetic Resonance Imaging)Clinical application value in nature.Materials and Methods: A total of 50 patients with limb and trunk soft tissue tumors diagnosed by postoperative pathology were enrolled,including 26 males and 24 females,aged 17-78 years(mean age 52.7 years).All patients underwent routine ultrasound,conventional MRI(ie,plain MRI+enhanced MRI),ARFI,and DWI before surgery.Conventional ultrasound was used to detect the size,shape,margin,tumor internal echo pattern and blood flow grading of soft tissue tumors.Using the VTQ(Acoustic Palpation Organization Quantification)technique to measure the shear wave velocity of different parts of each tumor lesion;using VTI(Virtual Touch Tissue Imaging)Techniques: After acquiring images,the soft tissue tumors were scored elastically and the tumor area ratio was determined.The size,shape,boundary,signal and enhancement mode of soft tissue tumors were measured by conventional MRI.The diffusion-weighted imaging was used to obtain the ADC value(Apparent Diffusion Coefficient)of the benign and malignant soft tissue tumors.Image acquisition,data recording and analysis of all cases were performed by two experienced physicians.The postoperative pathological results were used as the gold standard,and the measurement data were analyzed by independent sample t test.The statistical data were analyzed by ?2 test,and the sensitivity and specificity were analyzed.The binary logistic regression model was established and there will be statistics.Multi-factor analysis of indicators of academic significance.P<0.05,indicating that the difference was statistically significant,P? 0.05,suggested that the difference was not statistically significant.The data were tested using computer SPSS 22.0 statistical software.Results: In this study,50 soft tissue lesions,22 benign soft tissue tumors,and 28 malignant soft tissue tumors.1.Conventional ultrasound:(1)22 cases of benign soft tissue tumors conventional ultrasound findings:(1)Size: tumor size <25 cm2 14 cases,?25 cm2 8 cases.(2)Forms: 13 cases of irregularity,9 cases of round or round.(3)Borders: 14 cases were clear and 8 cases were blurred.(4)Internal echo: high or slightly higher echo in 8 cases,equal or low echo in8 cases,high and low mixed echo in 6 cases.(5)Blood flow classification: blood flow classification was 0 grade 5 cases,1 grade 10 cases,2 grade 4 cases,3 grades 3 cases.(2)28cases of malignant soft tissue tumors with conventional ultrasound findings:(1)Size: tumor size <25 cm2 9 cases,? 25 cm2 19 cases.(2)Forms: 16 cases of irregularity,12 cases of round or round.(3)Boundaries: 8 cases were clear and 20 cases were blurred.(4)Internal echo: high or slightly higher echo in 8 cases,equal or low echo in 9 cases,high and low mixed echo in 11 cases.(5)Blood flow classification: blood flow classification was 0 cases in 4 cases,1 level in 6 cases,2 in 6 cases,and 3 in 12 cases.The size of soft tissue tumors and the grade of blood flow in tumors in conventional ultrasound images were statistically significant in the diagnosis of benign and malignant soft tissue tumors(P<0.05).2.The average velocity of shear waves in benign tumors is(2.542±1.296)m/s,while the average shear wave velocity of malignant soft tissue tumors is(1.912±0.937)m/s.Shear wave velocity is in benign and malignant soft tissue tumors.In the diagnosis,the difference was not statistically significant(P>0.05).3.The average ratio of VTI area of ??benign tumor was 0.913±0.112,and the average ratio of VTI area of ??malignant tumor was 1.077±0.103.The ratio of VTI area was diagnosed in benign and malignant soft tissue tumors(P<0.01).4.Among the VTI elastic scores,there were 22 benign lesions,including 2 cases of grade I,7 cases of grade II,8 cases of grade III,4 cases of grade IV,1 case of grade V,and28 cases of malignant lesions,of which grade I was 0.For example,0 cases of grade II,4cases of grade III,14 cases of grade IV,and 10 cases of grade V.The VTI elasticity score was statistically significant in the diagnosis of benign and malignant soft tissue tumors(P<0.01).5.Routine MRI findings:(1)MRI findings of 22 benign soft tissue tumors:(1)Size:tumor size <25cm2 14 cases,?25 cm2 8 cases.(2)Forms: 13 cases of irregularity,9 cases of round or round.(3)Borders: 14 cases were clear and 8 cases were blurred.(4)Signals:T1WI showed low signal in 18 cases,slightly higher or higher signal in 4 cases;T2WI showed high or slightly higher signal in 22 cases.(5)Strengthening method: 7 cases were enhanced with uneven enhancement and 15 cases were evenly strengthened.(2)MRI findings of 28 cases of malignant soft tissue tumors:(1)Size: 9 cases of tumor size <25cm2,19 cases of ?25cm2.(2)Forms: 16 cases of irregularity,12 cases of round or round.(3)Borders: 15 cases were clear and 13 cases were blurred.(4)Signals: T1 WI showed low signal in 26 cases,slightly higher or higher signal in 2 cases;T2WI showed high or slightly higher signal in 28 cases.(5)Strengthening method: 18 cases with obvious enhancement and10 cases with uniform enhancement.The difference of soft tissue tumor size and tumor enhancement in conventional MRI images was statistically significant in the diagnosis of benign and malignant soft tissue tumors(P<0.05).6.The ADC value of benign tumors is(1.951±0.363)×10-3 mm2/s,while the ADC value of diffusion-weighted imaging(b=500s/mm2)for malignant soft tissue tumors is(1.170±0.263)×10-3 mm2/s.The ADC value was statistically significant in the diagnosis of benign and malignant soft tissue tumors(P<0.01).7.The area under the ROC curve of VTI area ratio,elastic score and ADC value were0.858,0.815 and 0.799,respectively;the area under the combined ROC curve was 0.901.Conclusion: The VTI area ratio of acoustic radiation force pulse elastography,the VTI elastic score of acoustic radiation force pulse elastography,and the ADC value of diffusion-weighted imaging have good diagnostic performance for the diagnosis of benign and malignant soft tissue tumors.In the VTQ mode of acoustic radiation pulse elastography,the shear wave velocity does not have a good diagnostic performance for the diagnosis of benign and malignant soft tissue tumors.VTI area ratio,elasticity score andADC value combined to evaluate the benign and malignant soft tissue tumors have certain clinical application value. |
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