| Objective:1. To explore the effects of the acoustic radiation force impulse (ARFI)technology on the diagnosis of benign and malignant tumors of kidney.2. To evaluate the effects of kidney tumors on the elasticity and hardness ofbilateral renal cortical tissues using the ARFI technology.Methods:A total of139renal tumors in139patients in our hospital were examined byvirtual touch tissue imaging (VTI) and virtual touch tissue quantification (VTQ)assays using the ARFI technology from March2012to January2014.1. All patients were classified with VTI examination. Then, the receiver operatingcharacteristic curve (ROC curve) was made, and the optimum diagnostic point wasfinding out. Calculate the degree of sensitivity, specific, Youden index and diagnosisaccuracy corresponding to the optimum diagnosis point.2. The shear wave velocity (SWV) values of renal tumors, renal cortex withtumors and contralateral renal cortex were measured using the VTQ examination.①The SWV values between renal cortex with tumors and contralateral cortex, benignand malignant tumors were compared using the paired t test;②The SWV values ofthe renal cortex with benign and malignant tumors, benign and malignant tumors,angiomyolipoma and clear cell carcinoma, chromophobe cell carcinoma, papillaryrenal cell carcinoma were compared using the independent samples t test;③TheSWV values of clear cell carcinoma, chromophobe cell carcinoma and papillary renalcell carcinoma were compared using the one-way ANOVA test;④The ROC curveof each diagnostic point were made, and the area under the curve, Youden index,sensitivity, specificity, the best cut-off point value and accuracy were calculated.Result：1. In the139renal tumors patients,24benign tumors and115malignant tumorswere involved.2. VTI classification of renal tumors:3of grade Ⅰ (2benign tumors and1 malignant tumor);22of grade Ⅱ (13benign tumors and9malignant tumors);32ofgrade Ⅲ(7benign tumors and25malignant tumors);69of grade Ⅳ(1benign tumorand68malignant tumors) and13of grade Ⅴ (1benign tumor and12malignanttumors).3. Grade Ⅳwas the best diagnostic point of renal tumors through the ROC curve.The diagnostic efficiency values of the grade Ⅳ were sensitivity69.6%, specificity91.7%, Youden index61.3%and accuracy73.4%, respectively.4. The SWV values between the renal cortex with tumor and contralateral renalcortex, between the renal cortex with benign tumor and the renal cortex withmalignant tumor showed no significant differences (P>0.05). The SWV valuesbetween benign or malignant tumors and the ipsilateral or contralateral renal cortexshowed statistically significance (P<0.05). The SWV values between benign andmalignant tumors showed statistical significance (P<0.05). The SWV values betweenangiomyolipoma and clear cell carcinoma, chromophobe cell carcinoma, papillaryrenal cell carcinoma showed statistically significance (P<0.05). There were nostatistical significance among the overall mean of cell carcinoma, clear cell carcinomaand too chromatography papillary renal cell carcinoma SWV values (F=1.157，P>0.05）; Moreover, there were no statistical significance between the overall meanSWV values of any two groups (P>0.05).5. The diagnostic efficiency value of the VTQ examination were: Area underthe ROC curve was0.866, sensitivity was77.4%, specificity was95.8%, Youdenindex was73.2%, accuracy was80.6%and the best cutoff point value was2.45m/s,respectively.6. The diagnostic efficiency values of VTI combined with VTQ examinationwere: sensitivity87.0%, specificity100%and accuracy89.2%.Conclusion:1. Acoustic radiation force impulse technology can react the overall and localflexibility and hardness of renal cortex and renal tumors.2. Acoustic radiation force impulse technology showed significant diagnosticefficiency on benign and malignant renal tumors.3. Renal tumor showed no effects on the elasticity and hardness of the ipsilateral and contralateral renal cortex of patients.4. VTI combined VTQ examination showed higher diagnostic accuracy than asingle method. |
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