| Objective 1.To explore the value of virtual touch tissue imaging(VTI)and virtual touch tissue quantification(VTQ)in differential diagnosis of breast masses.2.To explore the value of acoustic radiation force impulse(ARFI)imaging combined with breast imaging reporting and data system(BI-RADS)in diagnosis of breast masses.Methods 1.Patients 77 patients with 90 solid breast masses from the first affiliated hospital of Henan University of Traditional Chinese Medicine were studied.All patients were examined by conventional ultrasound and ARFI before surgery.ARFI includes VTI and VTQ.2.Method of operation First,in the conventional ultrasound mode,observe the size,shape,boundary,internal and posterior echo,blood flow signal,calcification and other indicators of the masses,and make BI-RADS classification.Then,Find the largest section of the masses,switched to ARFI imaging mode.In VTI imaging mode,the hardness of the masses were evaluated by Itoh 5 method.In VTQ imaging mode,the hardness of the masses were evaluated by the value of VTQ.The VTI scores and VTQ values of all masses were recorded.3.The statistical methods The masses were divided into benign and malignant group,according to the pathological results.Independent sample t-test was used to calculate the statistical difference between the VTI score and VTQ value of the two groups.According to the VTI score and VTQ value of the masses,the receiver operating characteristic(ROC)curve was drawn.Combined with VTI and VTQ,the ARFI score were calculated,the ROC curve was drawn.The comprehensive evaluation was combined with ARFI score and BI-RADS classification,the ROC curve was drawn.Find out the cut-off point of the curves,calculate the sensitivity,specificity,accuracy,Youden index,the area under the curve(AUC).The Z test was used to compare the AUC,and the diagnostic efficacy was obtained.Results 1.According to the pathological results,in 90 breast masses,58 were benign: among them,25 cases were fibroadenoma,17 cases were breast adenosis,4 cases were intraductal papilloma of breast,1 case was plasma cell mastitis;32 were malignant: among them,26 cases were invasive ductal carcinoma,4 cases were ductal carcinoma in situ,1 case was mucinous adenocarcinoma,1 case was intraductal papillary carcinoma.2.VTI imaging The average VTI score was 2.86±0.61 point of the benign group,the malignant group was 4.25±0.57 point,the difference between the two groups was statistically significant.According to the ROC curve,AUC was 0.94,the cut-off point was 3.5 point,the sensitivity was 93.8%,the specificity was 87.9%,and the accuracy was 90%.3.VTQ imaging The average VTQ value of the benign group was(2.80±0.69)m/s,the malignant group was(5.85±1.80)m/s,the difference between the two groups was statistically significant.According to ROC curve,AUC was 0.97,the cut-off point was 3.82m/s,the sensitivity was 87.5%,the specificity was 93.1%,the accuracy was 91.11%.4.ARFI imaging According to the ARFI score were calculated,the ROC curve was obtained.AUC was 0.93,the cut-off point was 1.5,the sensitivity was 87.5%,specificity was 93.1%,and accuracy was 91.11%.5.Comprehensive evaluation: According to the comprehensive score of the mass,the ROC curve was obtained.AUC was 0.98,the cut-off point is 2.5 points,the sensitivity was 90.6%,the specificity was 100%,the accuracy was 96.67%.6.According to Z test,the diagnostic efficiency of comprehensive evaluation was higher than that of ARFI(Z=2.16,P=0.03),the diagnostic efficiency of VTQ was higher than that of VTI score(Z=2.07,P=0.04).Conclusions 1.The hardness characteristics of different nature breast masses were significantly different.2.VTI imaging can make the qualitative diagnosis of breast masses,VTQ imaging can quantify the hardness of breast masses,and two methods both have great diagnostic value.The diagnostic efficiency of VTQ was higher than VTI.3.ARFI imaging combined with BI-RADS classification can improve the specificity and accuracy of the diagnosis of breast diseases. |
PDF Full Text Request