利用聲輻射力脈衝評估乳腺病變

Assessment of Breast Lesions by Using Acoustic Radiation Force Impulse Technique

劉春蘭(Chuen-Lan Liou) ； 張美彥(Mei-Yen Chang) ； 江惠如(Hui-Ru Chiang) ； 李靜姍(Ching-Shan Lee) ； 魏聰文(Jsong-Wen Wei) ； 王安中(An-Chueng Wang) ； 郭瓊文(Chiung-Wen Kuo) ； 賴亦貞(Yi-Chen Lai) ； 周宜宏(Yi-Hong Chou)

《中華放射線技術學雜誌》 41卷2期 (2017/06) Pp. 85-91

摘要

乳癌一直是全球女性的十大死因之一，近幾年乳房彈性超音波已成為測量腫瘤硬度最常使用的方法，利用人為操作壓迫乳房腫瘤，以獲得腫瘤硬度的動態彈性影像。聲輻射力脈衝技術為一種不需人為操作壓迫乳房腫瘤，藉由剪力波速值測量腫瘤軟硬度的利器。本研究的目的為利用聲輻射力脈衝技術的虛擬接觸定量影像的剪力波速，判讀腫瘤的軟硬度，以分析良性與惡性腫瘤的診斷準確率。本研究中有95位受檢者，96個腫瘤分別先以聲輻射力脈衝技術測量腫瘤特性，再以病理切片獲得組織病理學的驗證。經病理切片驗證後共有44個為良性腫瘤52個為惡性腫瘤，66個有測量值，包含36個良性腫瘤與30個惡性腫瘤；30個無測量值，包含8個良性腫瘤與22個惡性腫瘤。本研究經由聲輻力脈衝技術的虛擬接觸定量影像數據的結果顯示，有測量值的惡性腫瘤中心比良性腫瘤中心的硬度硬，且有顯著的差異（p=0.02）。分辨良惡性腫瘤的剪力波速最佳切點為2.81 m/s，其敏感度40.0%；特異性91.7%。研究結果顯示剪力波速可提供乳房組織客觀定量的測量，並得到良惡性腫瘤的剪力波速最佳切點的參考值，結合BI-RADS分類可提高乳房腫瘤的鑑別診斷，並能減少不必要的切片及病人的不適，以節省醫療資源與提升服務品質。

關鍵字

乳房彈性超音波 ； 聲輻射力脈衝 ； 虛擬接觸定量影像 ； 剪力波速

並列摘要

Breast cancer has been one of the world's most common cancer deaths in women. Recently, the elastography has become the useful method for measuring the degree of hardness at tumor lesion by compression breast tumor. Acoustic radiation force impulse technique (ARFI) is another modality to measure the shear wave velocity of breast lesions without human oppression. The purpose of this study was to assess the accuracy of diagnosing breast cancer by using the ARFI technique of virtual touch quantitative imaging (VTQI) shear wave velocity (SWV). Ninety-five patients were enrolled in this study. All 96 tumors (44 benign tumors and 52 malignant tumors) were proved by pathological biopsy. 66 tumors (36 benign tumors and 30 malignant tumors) have shown share wave velocity value, whereas 30 tumors (8 benign tumors and 22 malignant tumors) could not demonstrate any shear wave velocity value. The results demonstrated that the center of malignant tumor was significant harder than benign tumor (p=0.02). The cut-off point was 2.81 m/s for distinguishing the malignant tumor and benign tumor (sensitivity 40.0%, specificity 91.7%). The results proved the SWV could provide effective measurements of the breast tissues, and got the reference cut-off point of SWV of benign and malignant tumors of our country. Furthermore, the SWV combine with BI-RADS classification could improve the diagnosis of breast tumor to reduce the unnecessary biopsy.

並列關鍵字

elastography ； acoustic radiation force impulse technique ； virtual touch quantification imaging ； shear wave velocity