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目的:探讨声触诊组织量化(VTQ)技术用于鉴别乳腺实性肿块良恶性质的临床价值。方法:选择乳腺肿瘤98例共108个实性肿块,应用VTQ技术分别获得代表肿块中央部位及周围正常腺体硬度的剪切波速度(VS),再与病理检查结果对照,比较良恶性乳腺肿块VS的差异,应用ROC曲线获得最佳截断值(cutoff),并判断指标的诊断效能,同时分别比较良恶性乳腺肿块中央部位与周围正常腺体VS的差异。结果:良性乳腺肿块与正常腺体VS均值分别为(2.62±1.82)m/s、(1.31±0.18)m/s,两者比较差异非常显著(P<0.01);恶性乳腺肿块与正常腺体VS均值分别为(6.96±2.50)m/s、(1.26±0.25)m/s,两者比较差异非常显著(P<0.01);恶性乳腺肿块与良性乳腺肿块VS均值分别为(6.96±2.50)m/s、(2.62±1.82)m/s,两者比较差异非常显著(P<0.01)。ROC曲线获得最佳cutoff值为2.78m/s;以VS>2.78m/s诊断为恶性与病理结果对照,VTQ技术诊断恶性乳腺肿块的敏感度为91.18%,准确度为89.74%,特异性为88.64%,与病理结果高度一致(Kappa=0.793,P<0.01)。结论:VTQ评估有助于鉴别乳腺实性肿块的良恶性质。
Objective: To investigate the clinical value of acoustic palpation Tissue Quantification (VTQ) in identifying benign and malignant breast masses. Methods: A total of 108 solid tumors were selected from 98 cases of breast tumors. The shear wave velocity (VS), which represents the hardness of the central part of the tumor and the surrounding normal glands, was obtained by using VTQ technique. Compared with the results of pathological examination, benign and malignant breast masses VS, the best cutoff value was obtained by ROC curve, and the diagnostic efficiency of the index was judged. At the same time, the difference between the central part of benign and malignant breast mass and the surrounding normal gland VS was compared respectively. Results: The average VS of benign breast mass and normal gland were (2.62 ± 1.82) m / s and (1.31 ± 0.18) m / s respectively, with significant difference between the two groups (P <0.01) (6.96 ± 2.50) m / s and (1.26 ± 0.25) m / s, respectively (P <0.01). The average VS of malignant breast mass and benign breast mass were (6.96 ± 2.50) m / s, (2.62 ± 1.82) m / s, the difference between the two was significant (P <0.01). The best cutoff value of ROC curve was 2.78 m / s. The diagnosis of malignant and pathological results with VS> 2.78 m / s was 91.18%, the accuracy was 89.74% and the specificity was 88.64%, which was highly consistent with pathological findings (Kappa = 0.793, P <0.01). Conclusion: The VTQ assessment can help identify the benign and malignant features of solid breast masses.