| 摘要: |
| 目的 探讨声辐射力脉冲成像（ARFI）技术对乳腺良恶性肿块的诊断价值，分析绝经状态对其诊断效能的影响。方法 收集经我院病理证实的191例乳腺肿块患者，均行常规超声检查、静态应力式弹性成像及声触诊组织定量技术检查，应用Logistic回归模型筛选出诊断乳腺良恶性肿块最有价值的指标，构建受试者工作特征（ROC）曲线并比较其诊断效能；多因素方差分析绝经状态对VTQ定量技术诊断乳腺恶性肿块效能的影响。结果 常规超声检出BI-RADS 3类55个，BI-RADS 4类120个（包括4A类16个，4B类57个，4C类 47个），BI-RADS 5类22个。恶性肿块的弹性评分、内部区域和边缘区域的SWV值、内部区域与对侧同层腺体、边缘区域与对侧同层腺体的SWV比值均高于良性肿块，差异均有统计学意义（均P＜0.05）。多因素Logistic回归分析显示弹性成像评分（X1）、内部区域SWV值（X2）、边缘区域SWV值（X3）先后进入回归方程为：Y=-9.966+0.847X1+1.072X2+1.274X3，其诊断敏感性和特异性分别为（90.52%，90.24%）。内部区域SWV值、边缘区域SWV值、弹性成像评分和BI-RADS分类法诊断乳腺肿块良恶性的ROC曲线下面积分别为0.926、0.927、0.807和0.892。多因素方差分析显示绝经与乳腺肿块良恶性两种因素对VTQ数值的影响不存在交互作用。结论 ARFI技术对乳腺良恶性肿块的诊断价值较高，且其诊断效能不受绝经状态影响。 |
| 关键词: 声辐射力脉冲成像技术 超声 乳腺肿瘤 绝经 |
| DOI： |
| 投稿时间：2018-06-21修订日期：2019-03-31 |
| 基金项目: |
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| Analysis of the influence of menopausal status on the value of ARFI in the diagnosis of benign and malignant breast tumors by logistic regression model |
| huangzhifang,Xu Ping |
| (Huashan Hospital Affiliated to Fudan University) |
| Abstract: |
| Objective To investigate the diagnostic value of ARFI technology for benign and malignant breast tumors，and further explore the effect of menopausal status on the diagnostic efficiency. Methods One hundred and ninety-one patients （197 lesions），confirmed by histopathology of our hospital, were examined by conventional ultrasonography，static stress elastography and acoustic palpation tissue quantitative technique （VTQ）. The Logistic regression model was used to detect the most valuable indicators for the diagnosis of breast cancer，and the ROC curve was constructed to compare the diagnostic value and to determine the effect of menopause on its diagnostic efficiency. Results Conventional ultrasound detected 55 BI-RADS 3, 120 BI-RADS 4 (including 16 in 4A, 57 in 4B, 47 in 4C), and 22 in BI-RADS 5.There was a significant difference in the elastic score between benign and malignant breast lesions, and the shear wave value （SWV） in the internal area and the marginal area （P＜0.05）.Multivariate logistic regression analysis showed that the elastography score (X1), the internal region SWV value (X2), and the edge region SWV value (X3) entered the regression equation successively: Y=-9.966+0.847X1+1.072X2+1.274X3, its diagnostic sensitivity and specificity were 90.52% and 90.24%. The area under the curve constructed by BI-RADS classification，elastography score, the SWV values of the internal area，and the SWV value of the marginal region are 0.892,0.807,0.926 and 0.927, respectively. Multivariate analysis of variance showed that there was no association between menopausal status，histopathology and the VTQ value （P>0.05）.Conclusion ARFI technology is of high value in the differential diagnosis of benign and malignant breast Tumors, and its diagnostic efficiency might not be affected by menopausal status. |
| Key words: ARFI Ultrasonography Breast neoplasms Menopause |
