ARFI联合导管内窥镜对病理性乳头溢液疾病的诊断价值

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摘要目的探讨声辐射力脉冲成像（ARFI）联合导管内窥镜（FDS）在病理性乳头溢液扩张乳管良恶性鉴别诊断中的价值。方法选择2017年8月~2018年7月川北医学院附属医院超声科并获得明确病理结果的乳头溢液患者35例（46条乳管）作为研究对象。溢液侧乳房术前均行ARFI、FDS检查，绘制ROC曲线，记录曲线下面积（AUC）。结合病理结果，比较ARFI、FDS对乳头溢液侧乳管内良恶性疾病的诊断价值。结果 ARFI、FDS均有助于乳腺良恶性病变的鉴别诊断，其中以ARFI中的声触诊组织成像与量化技术（VTIQ）诊断价值最大，临界值为3.55时预测恶性肿瘤的敏感度为100.0%，特异性为82.9%。VTIQ联合FDS诊断准确率为91.3%，误诊率为8.7%，但是与VTIQ、FDS单独诊断比较，差异无统计学意义（P > 0.05）。结论 FDS、ARFI均有助于溢液侧乳房乳管内良恶性肿瘤的鉴别，ARFI与FDS相结合能提高导管内占位良恶性诊断的准确率，降低误诊率。

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	唐雪梅1 袁红梅1 侯令密2 任敏2 谢少利2 顾鹏1

关键词 ：乳头溢液, 弹性成像, 导管内窥镜, 声辐射力脉冲成像

Abstract：Objective To investigate the value of acoustic radiation force impulse (ARFI) combined with fiber duct endoscopy (FDS) in diagnosis of pathology nipple galactorrhea. Methods A total of 35 patients (46 milk ducts) with nipple discharge from the Department of Ultrasound, Affiliated Hospital of North Sichuan Medical College from August 2017 to July 2018 with definite pathological results were selected as the study subjects. ARFI and FDS examinations were performed on the overflow side of the breast before surgery, ROC curve was drawn and the area under the curve (AUC) was recorded. Combined with the pathological results, the diagnostic value of ARFI and FDS in benign and malignant diseases of the nipple discharge side duct was compared. Results ARFI and FDS were helpful to distinguish the lesions. Virtual touch image quantification(VTIQ) of ARFI was most useful. When the critical value of VTIQ was 3.55, the sensitivity and specificity of predicting malignant tumors were 100.0% and 82.9%. The diagnostic accuracy of VTIQ combined with FDS were 91.3 %, and the misdiagnosis rate was 8.7%. However, compared with VTIQ and FDS, the difference was not statistically significant (P > 0.05). Conclusion Both ARFI and FDS are helpful to identify the tumor of pathological benign or malignant. ARFI combines with FDS can improve the diagnostic of accuracy, reduce the misdiagnosis.

Key words： Galactorrhea Ultrasonography Fiber duct endoscopy Acoustic radiation force impulse

基金资助: 四川省省级科技计划-应用基础研究计划项目（2019YJ0709）。

作者简介: 唐雪梅（1984.9-），女，硕士；研究方向：浅表器官的超声诊断。

引用本文:

唐雪梅1 袁红梅1 侯令密2 任敏2 谢少利2 顾鹏1. ARFI联合导管内窥镜对病理性乳头溢液疾病的诊断价值[J]. 中国医药导报, 2020, 17(16): 147-150.
TANG Xuemei1 YUAN Hongmei1 HOU Lingmi2 REN Min2 XIE Shaoli2 GU Peng1. Diagnostic value of acoustic radiation force impulse combined with fiber duct endoscopy in pathology nipple galactorrhea. 中国医药导报, 2020, 17(16): 147-150.

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http://www.yiyaodaobao.com.cn/CN/ 或 http://www.yiyaodaobao.com.cn/CN/Y2020/V17/I16/147

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