Feasibility Study Of Peripheral Lung Tumors Assessed By Acoustic Radiation Force Impulse Elastography Technology

Objective: To discuss the diagnostic value of benign and malignant peripherallung tumor and tumor-like lesions with acoustic radiation force impulse elastography(ARFI). And to provide convenient and reliable basis to the clinical treatment.Methods: Seventy-four inpatients (74lesions generally select will be the site ofthe ultrasonic surgical intervention puncture) who were diagnosed as peripheral lungtumor from October2011to October2012First Affiliated Hospital of HenanUniversity of Science and Technology were selected. Preoperative routineexaminations by color Doppler ultrasound were carried on patients exposed lesion ofthe right posture. By repeated scanning of the tumor site and choosing an appropriatearea of interest, location, size, shape, border, internal echo, posterior echo with orwithout attenuation, aspect ratio of the tumor were observed. The peripheral andinternal blood supplies were also observed by Color Power Doppler. At last, SWV ofthe tumor were mainly obtained by ARFI technology. The difference between elasticimaging characteristics and shear wave velocity were statically analyzed and ROCcurve of SWV was used to evaluate the differential diagnosis of benign and malignantperipheral lung mass as well as their cut-off point.Results: The pathological results of the74cases of lung tumor patients:20caseswith lung squamous cell carcinoma,17cases with lung adenocarcinoma,6cases withsmall cell lung cancer,29cases with inflammation organizations infiltration,1casewith primitive neuroectodermal tumor and1case with solitary fibrous tumor. Amongthem there are44malignant lesions and30benign lesions. The values of shear wavevelocity (SWV)(0.91±0.32) m/s from benign lesions were significantly lower thanthe value of the shear wave velocity (SWV)(1.54±0.44) m/s from malignant lesions.By the analysis of SPASS19.0statistical software, P=0.000<0.05, the gap isstatistically significant. In malignant group, compares values of shear wave velocity(SWV) between lung adenocarcinoma and lung carcinoma [(1.38±0.43) m/s VS (1.40 ±0.41) m/s], analyzed by SPASS19.0statistical software, results in no statisticallysignificant difference, P=0.92>0.05. By comparing the benign and malignant group,building the ROC curve, the cutoff value of benign and malignant lesions wereobtained. Choosing1.2m/s as the cut-off point of the differentiation of benign andmalignant lesions, malignancy sensitivity, specificity, positive predictive value,negative predictive value are77.3%,80%,84.3%, and52.6%.Conclusion: ARFI is feasible for the assessment of benign and malignantperipheral lung masses. Combined with conventional two-dimensional ultrasound andcolor Doppler imaging, it has shown a perfect application in the early diagnosis andidentification of benign and malignant tumor.