Quantitative assessment of breast lesion viscoelasticity: Initial clinical results using supersonic shear imaging
Quantitative assessment of breast lesion viscoelasticity: Initial clinical results using supersonic shear imaging
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DOI：
10.1016/j.ultrasmedbio.2008.02.002
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发表时间：
2008-09-01
影响因子：
2.9
通讯作者：
Fink, Mathias
中科院分区：
文献类型：
--
作者：
Tanter, Mickael;Bercoff, Jeremy;Fink, Mathias
本文提出了一个初步的临床评价，在体内弹性成像乳腺病变成像的概念，超声剪切成像。该技术基于由超声波束在组织中引起的辐射力和能够在真实的时间中捕获所产生的剪切波的传播的超快成像序列的组合。使用飞行时间技术恢复局部剪切波速度，并实现剪切弹性的2-D映射。这种成像方式是在由专用超快回波描记设备驱动的传统线性探头上实现的。因此，它可以在标准回波描记检查期间执行。对15例患者进行了临床研究，对应于15个病变（4例BI-RADS 3，7例BI-RADS 4和4例BI-RADS 5）。超声剪切成像技术的能力，以提供一个定量和局部估计的剪切模量的异常与毫米级的分辨率上说明了几个恶性（浸润性导管和小叶癌）和良性的情况下（纤维囊性变化和粘性囊肿）。在调查的情况下，恶性病变被发现是显着不同的良性固体病变方面的弹性值。囊性病变显示在病变中根本没有剪切波传播（因为剪切波在液体中不传播）。这些初步的临床结果直接证明了这种新的弹性成像技术在提供乳腺组织相对硬度的定量评估方面的临床可行性。这种评估组织弹性的技术提供了与B型形态学信息互补的有价值的信息。需要更广泛的研究来验证这种新模式可能有助于医生进行假阳性和假阴性拒绝的假设。
This paper presents an initial clinical evaluation of in vivo elastography for breast lesion imaging using the concept of supersonic shear imaging. This technique is based on the combination of a radiation force induced in tissue by an ultrasonic beam and an ultrafast imaging sequence capable of catching in real time the propagation of the resulting shear waves. The local shear wave velocity is recovered using a time-of-flight technique and enables the 2-D mapping of shear elasticity. This imaging modality is implemented on a conventional linear probe driven by a dedicated ultrafast echographic device. Consequently, it can be performed during a standard echographic examination. The clinical investigation was performed on 15 patients, which corresponded to 15 lesions (4 cases BI-RADS 3, 7 cases BI-RADS 4 and 4 cases BI-RADS 5). The ability of the supersonic shear imaging technique to provide a quantitative and local estimation of the shear modulus of abnormalities with a millimetric resolution is illustrated on several malignant (invasive ductal and lobular carcinoma) and benign cases (fibrocystic changes and viscous cysts). In the investigated cases, malignant lesions were found to be significantly different from benign solid lesions with respect to their elasticity values. Cystic lesions have shown no shear wave propagate at all in the lesion (because shear waves do not propage in liquid). These preliminary clinical results directly demonstrate the clinical feasibility of this new elastography technique in providing quantitative assessment of relative stiffness of breast tissues. This technique of evaluating tissue elasticity gives valuable information that is complementary to the B-mode morphologic information. More extensive studies are necessary to validate the assumption that this new mode potentially helps the physician in both false-positive and false-negative rejection.