摘要目的 探讨应用声脉冲辐射力弹性成像(ARFI)技术联合常规超声在诊断乳腺肿块性质中的应用.方法 选择2013年1月至2014年1月因乳腺肿块来本院进行超声检查的乳腺疾病女性患者102例,根据肿块直径分为3组(＞20 mm、10～20 mm、＜10 mm),行二维超声检查、彩色多普勒观察及ARFI弹性成像检查,分析ARFI联合常规超声以及单纯使用常规超声检查乳腺疾病的特异度和灵敏度,比较各组内良、恶性肿块剪切波速度(SWV)数值差异及各组间肿块SWV数值差异.结果 ARFI联合常规超声的灵敏度95.2％,特异度98.8％,常规超声的灵敏度81.0％,特异度92.6％,两者灵敏度及特异度比较,差异均有统计学意义(均P＜0.05).恶性肿块的SWV数值(5.61±0.16)m/s(肿块直径＞20mm)、(3.35±0.24)m/s(肿块直径10～20 mm)、(2.42±0.11)m/s(肿块直径＜10 mm)较良性肿块的SWV数值(3.00±0.12)m/s(肿块直径＞20 mm)、(2.11±0.06)m/s(肿块直径10～20 mm)、(2.03±0.10)m/s(肿块直径＜10 mm)明显升高(均P＜0.05).与＞20 mm组的SWV值比较,恶性、良性肿块直径＜10 mm、10～20 mm组的SWV值明显降低(均P＜0.05).结论 ARFI联合常规超声可明显提高乳腺肿块良恶性的诊断灵敏度及特异度.

abstractsObjective To determine the value of acoustic radiation force impulse elastography (ARFI) combined with conventional ultrasound in identifying the nature of breast masses.Methods A total of 102 female patients who visited our hospital between January 2013 and January 2014 for ultrasonography of breast masses were included in the study.According to tumor size,the patients were divided into 3 groups (＞20 mm,10-20 mm,and ＜10 mm),and all of them underwent two-dimensional ultrasonography,color Doppler ultrasonography and ARFI.We analyzed the diagnostic specificity and sensitivity for breast diseases between conventional ultrasonography alone and combined with ARFI.The differences in shear wave velocity (SWV) of benign and malignant tumors were compared within and between groups.Results ARFI combined with conventional ultrasonography yielded a sensitivity of 95.2％ and a specificity of 98.8％,compared with a sensitivity of 81.0％ and a specificity of 92.6％ by conventional ultrasonography alone,with statistical significant differences (all P＜0.05).The SWV for malignant tumors [(5.61 ± 0.16) m/s (＞20 mm),(3.35 ± 0.24) m/s (10-20 mm),(2.42±0.11) m/s (＜10 mm) was significantly greater than that for benign tumors [(3.00±0.12) m/s (＞20 mm),(2.11±0.06) m/s (10-20 mm),(2.03±0.10) m/s (＜10 mm)] (all P＜0.05).Compared with tumor size ＞20 mm,either malignant or benign tumors with a size ＜10 mm or 10-20 mm was with significantly lower SWV (all P＜0.05).Conclusion ARFI combined with conventional ultrasonography can remarkably improve the diagnostic sensitivity and specificity for benign and malignant breast masses.