The Discussed Of Acoustic Radiation Force Impulse In Differentiating The Benign Or Malignant Tumors Of Breast

Objective1To explore the diagnostic value of conventional ultrasound and Energy Doppler in benign and malignant breast solid nodules identification.2To explore the value of application use acoustic radiation force impulse technology in differentiating the Benign or Malignant tumors of Breast. Analysing the related factors of the hardness in breast carcinoma which compared with histopathology.3To get the cut-off value of the grade of the Benign or Malignant tumors of Breast by measuring the ROC (Receiver Operator Characteristic) curve. Providing reference for the clinical noninvasive assessment of tumors of Breast and treatment formular.4To compare the diagnostic value of conventional ultrasound and Energy Doppler and Virtual touch tissue quantification and Virtual touch tissue quantification four methods of identification of benign and malignant solid nodules of the breast.Materials and Method98female patients with108breast solid nodules were examined during July2012to January2013were performed in Hospital. All the patients enrolled in the research who went to our hospital for physical examinations received the surgery. And every lesion thereafter underwent pathological assessments. ARFI was performed using a ACUSON S2000scanner(Siemens company) with a9L4probe (4--9MHz) which equipped with the software of ARFI. Patients may take lateral position or supine position when the wereexamined. Every breast lesions were performed by2D ultrasonic imaging firstly,Which contained the size、 shape、boundary and echo inside in the tumors. Then, started the color Doppler flow imaging mode to observe the blood flow condition of the breast tumors of,using Doppler ultrasound technology measure the peak flow velocity,acceleration and resistance index which inside the breast tumor and surrounding the tumors. ARFI in patients with breast nodules, detecting each lesion via Virtual Touch tissue Imaging (VTI) and Virtual Touch tissue Quantification (VTQ). Then get the VTI of breast solid nodules, identify the tissue texture by echo intensity (more strong echo stand for more soft of the tissue, more weak echo stand for more hard of the tissue). Every patient experienced five times VTQ and the average results of VTQ tests was calculated and showed by mean士SD. The postoperative pathology used as a standard to determine benign or malignant of the nodules, the difference of elastic parameters between benign and malignant breast nodules was analyzed statistically (P<0.05).Result1The accuracy, sensitivity, specificity of evaluation of benign and malignant solid nodules by using conventional ultrasound were86.11%,85.71%and86.44%.2The accuracy, sensitivity, specificity of evaluation of the semi quantitative methods which put forward by Adler of CDFI grade in diagnosis of breast tumorous is76.85%、71.43%、81.36%。3The accuracy, sensitivity, specificity of evaluation of benign and malignant solid nodules by using the Virtual touch tissue quantification were92.71%、92.31%、92.98%. The interior average value of VTQ of benign tumors is2.865±0.472m/s,the average value of VTQ surround the benign tumors is2.659±0.437m/s.The interior average value of VTQ of malignancy is4.828±1.171m/s, the average value of VTQ surround the malignancy is4.170±0.985m/s.The VTQ value has significant difference between benign and malignant tumors(P<0.01),the VTQ value surround the tumor has significant difference between benign and malignant tumors(P<0.01). The interior average value of VTQ of benign tumors of The mammary gland is2.315±0.411m/s, The interior average value of VTQ of malignancy mammary gland is2.617±0.590m/s. Both compared with no statistical difference (P>0.05). The same patients with benign lesions within the VTQ average compared with average junction VTQ, with no statistical difference (P>0.05), the same average junction VTQ in patients with benign lesions and normal mammary gland tissue between VTQ values compared with no statistical difference (P>0.05). The same patients with malignant lesions within the VTQ average compared with average junction VTQ, with statistical difference (P<0.01). Malignant lesions in patients with the same junction VTQ average compared with the normal mammary gland tissue between VTQ average, with statistical difference (P<0.01).4. The accuracy, sensitivity, specificity of evaluation of benign and malignant solid nodules by using Acoustic radiation force impulse were83.33%、100.00%、69.49%。Conclusion1ARFI technology is a non-invasive, real-time elastic testing technology, simple and practical, easy to operate, can be more objective quantitative qualitative evaluation organizations hardness, VTI qualitative identification of benign and malignant breast nodules. VTQ values in this study to3.69m/s is bounded, can prompt to distinguish breast nodules benign mammary gland nodules with malignant group, Sound pulse radiation imaging (ARFI) is a clinical diagnosis of mammary gland disease provides a new idea.2Using shear wave can’t potential characteristics in the liquid, when ordinary two-dimensional ultrasound showed atypical complicated cystic lesion, according to the acoustic pulse radiation elasticity imaging (ARFI) the characteristics of shear waves in a liquid are not propagated to identify atypical cystic lesion.3ARFI technology combined with conventional two-dimensional ultrasound examination can improve the differential diagnosis of benign and malignant breast nodules.