目的：探讨采用声脉冲辐射力弹性成像技术（ARFI技术）鉴别诊断周围型肺部肿块良、恶性的临床应用价值。方法：收集2015年10月至2016年10月在本院住院诊断为周围型肺部肿块患者118例（118个病灶），所有患者同时行常规超声及ARFI检查，以病理结果为金标准，对比分析不同病理类型肺部肿块之间二维常规超声征象与ARFI技术剪切波速度（SWV）之间的差异。结果：良性病灶的SWV值为（0.87±0.59）m·s^-1，明显低于恶性病灶的（1.58±0.63）m·s^-1，差异有统计学意义（P<0.05）；以SWV值≥1.3 m·s^-1作为判定良恶性病灶的分界点，其灵敏度、特异性、准确率分别为85.1%、84.1%、87.7%，约登指数为0.670；恶性组中肺腺癌和肺鳞癌SWV值比较，差异无统计学意义（P>0.05）；常规超声与ARFI技术联合诊断时可提高诊断的灵敏度（χ²=11.105，P=0.004）。结论：随着肺部肿块硬度的增高其SWV值随之增高，ARFI技术在一定程度上能够评估周围型肺部肿块的良恶性，可用于临床鉴别诊断周围型肺部肿块。

[1] 张兵林,笪冀平.WHO(2015)肺肿瘤组织学分类解读[J].诊断病理学杂,2016,23(6):401-407.
[2] 梅文娟,张周龙.声脉冲辐射力弹性成像技术评估周围型肺部肿瘤的可行性研究[J].临床肺科杂志,2015,18(8):1477-1478.
[3] 郭万学.超声医学[M].6版.北京:人民军医出版社,2013:760-774.
[4] MOUGENOT C,PICHARDO S,ENGLER S,et al.A rapid magnetic resonance acoustic radiation force imaging sequence for ultrasonic refocusing[J].Phys Med Biol,2016,61(15):5724-5740.
[5] AL-WAKEEL J S.Outcome of early ambulation after renal biopsy using automated biopsy needle by inexperienced trainees[J].Int Urol Nephrol,1998,30(4):399-405.
[6] LIU H,FU J,HONG R,et al.Acoustic radiation force impulse elastography for the non-invasive evaluation of hepatic fibrosis in non-alcoholic fatty liver disease patients:a systematic review & meta-analysis[J].PLoS One,2015,10(7):1-10.
[7] 王蕾,韦康来,李智贤,等.T1期乳腺浸润性导管癌的硬度与胶原纤维关系的初步研究[J].中国超声医学杂志,2015,31(9):783-786.
[8] 李玉林.病理学[M].6版.北京:人民卫生出版社,2004:182-186.
[9] 姚晓军,刘伦旭.肺癌的流行病学及治疗现状[J].现代肿瘤医学,2014(8):1982-1987.
[10] ZENG C,WEN W,MORGANS A K,et al.Disparities by race,age,and sex in the improvement of survival for major cancers:results from the National Cancer Institute Surveillance,Epidemiology,and End Results (SEER) Program in the United States,1990 to 2010[J].JAMA Oncol,2015,1(1):88-96.
[11] ZHANG X,QIANG B,HUBMAYR R D,et al.Noninvasive ultrasound image guided surface wave method for measuring the wave speed and estimating the elasticity of lungs:a feasibility study[J].Ultrasonics,2011,51(3):289-295.
[12] MAS K,ABBASY M,ABOZEID M,et al.Assessment of liver fibrosis with acoustic radiation force impulse imaging versus liver histology in patients with chronic hepatitis C:a pilot study.[J].Eur J Gastroenterol Hepatol,2017,29(8):951-955.
[13] GOERTZ R S,SCHUDERER J,STROBEL D,et al.Acoustic radiation force impulse shear wave elastography (ARFI) of acute and chronic pancreatitis and pancreatic tumor[J].Eur J Radiol,2016,85(12):2211-2216.
[14] BOTA S,SPOREA I,ŞIRLI R,et al.How useful are ARFI elastography cut-off values proposed by metaanalysis for predicting the signifcant fbrosis and compensated liver cirrhosis?[J].Med Ultrason,2015,17(2):200-205.
[15] 郭莉,余小琴,郝轶,等.超声弹性应变率比值法与评分法鉴别乳腺结节良恶性的对比研究[J].现代医学,2015,43(7):844-847.
[16] 韦小葵,冼丽娅,韦艳华,等.超声弹性成像在甲状腺良恶性小结节诊断中的价值[J].东南大学学报(医学版),2015,34(1):55-58.