Abstract: Background　Breast cancer is a common malignant tumor in women.The acoustic radiation force impulse imaging（ARFI） and superb microvascular imaging（SMI） are common screening and diagnosis methods of early breast cancer，but each of them has its own advantages and disadvantages.So far，the application of ARFI combined with SMI in the diagnosis of early breast cancer has not been reported.Objective　To investigate the screening and diagnosis value of ARFI in combination with SMI in early breast cancer.Methods　160 cases with breast lump as a primary manifestation visiting Anhui Provincial Hospital Affiliated to Anhui Medical University from January 2017 to December 2018 were enrolled.All of them accepted ARFI quantification，SMI，and pathological examination successively.Consistence of examination result with pathological findings，sensitivity，and specificity were compared between ARFI，SMI，and ARFI in combination with SMI.Results　124 cases of early breast cancer and 36 cases of benign lesions were confirmed by pathological examination，and the diagnosis rate of breast cancer was 72.3%.The consistence of ARFI，SMI，and ARFI in combination with SMI results with pathological results was moderate，moderate and very good，respectively（Kappa=0.569，0.529，0.880，P<0.05）.The mean sensitivity of ARFI，SMI and ARFI with SMI was 79.8%，78.2%，and 95.2%，respectively，showing a significant difference （P<0.05）.And the combination of ARFI and SMI showed a higher mean sensitivity than each alone（P<0.05）.The mean specificity of ARFI，SMI and ARFI with SMI was 88.9%，86.1%，and 97.2%，respectively，demonstrating no obvious difference （P>0.05）.Conclusion　ARFI and SMI are both important examinations in screening and diagnosing early breast cancer.And combined use of the two may increase diagnostic sensitivity，which can be used clinically according to patients' specific conditions.

Key words: Breast neoplasms；Ultrasonography, mammary；Elasticity imaging techniques；Superb microvascular imaging；Screening and diagnosis

摘要： 背景　乳腺癌是女性常见的恶性肿瘤，超声声脉冲辐射力弹性成像（ARFI）量化技术和超微血管成像（SMI）检查是早期乳腺癌的常用筛查诊断手段，但二者各具优缺点，超声ARFI量化技术联合SMI检查应用于早期乳腺癌诊断的研究较少。目的　探讨超声ARFI量化技术联合SMI检查对早期乳腺癌的筛查诊断价值。方法　收集2017年1月—2018年12月于安徽医科大学附属省立医院就诊的以乳腺肿块为主要临床表现的160例患者作为研究对象，均行ARFI和SMI检查，其中ARFI采用量化技术进行处理，ARFI和SMI检查之后行病理检查。分别比较ARFI检查、SMI检查、ARFI+SMI检查与病理检查结果的一致性、灵敏度和特异度。结果　160例患者经病理检查确诊为早期乳腺癌124例、良性病变36例；早期乳腺癌确诊率为72.3%。ARFI检查、SMI检查、ARFI+SMI检查与病理结果一致性程度分别为中、中、优（Kappa=0.569、0.529、0.880，P<0.05）。ARFI检查筛查诊断早期乳腺癌的灵敏度、特异度分别为79.8%和88.9%，SMI检查筛查诊断早期乳腺癌的灵敏度、特异度分别为78.2%和86.1%，ARFI+SMI检查筛查诊断早期乳腺癌的灵敏度、特异度分别为95.2%和97.2%。不同检查方法灵敏度比较，差异有统计学意义（P<0.05）；不同检查方法特异度比较，差异无统计学意义（P>0.05）；组间比较显示，ARFI+SMI检查的灵敏度高于ARFI、SMI检查（P<0.05）。结论　ARFI检查和SMI检查均是早期乳腺癌筛查诊断的重要检查方法，而两种检查方法联合应用能够提高早期乳腺癌筛查诊断的灵敏度，临床上可根据具体情况选择ARFI量化技术联合SMI检查对早期乳腺癌进行筛查诊断。

关键词: 乳腺肿瘤；超声检查, 乳房；弹性成像技术；超微血管造影；筛查诊断