摘要
目的：探讨剪切波超声弹性成像（SWE）在乳腺良恶性疾病鉴别诊断中的价值。方法选择茂名市人民医院2012年1月～2014年1月收治的女性乳腺疾病患者208例作为研究对象，采用SWE与乳腺影像报告与数据系统（BI-RASD）对所有患者进行定性诊断，比较乳腺腺体及良恶性病变的弹性模量值，并比较弹性最大值、弹性平均值及BI-RASD对乳腺良恶性疾病的诊断效能。结果病理诊断良性病灶176个，恶性病灶60个。SWE成像乳腺纤维瘤、乳头状瘤及乳腺病以均一的蓝色为主要表现，炎性脓肿以蓝色为主，内部可见未着色区；浸润性导管癌、浸润性小叶癌和导管内癌主要表现红色为主的杂乱色彩，导管内乳头状癌以蓝色为主，内部可见红色及无着色区域。恶性病变弹性最大值、弹性平均值均大于良性病变和乳腺腺体组织（P〈0.01），良性病变大于乳腺腺体组织（P〈0.01），弹性最小值良恶性病变差异无统计学意义（P〉0.05），但均大于乳腺腺体（P〈0.01）。弹性最大值诊断乳腺疾病的敏感性、特异性和准确度与BI- RASD分级比较差异有统计学意义（χ2=17.788、26.072、4.470，P=0.000、0.000、0.035）。结论 SWE操作简单、无需加压，可直接显示出病灶的弹性值，能够客观、量化评价病灶内部的硬度，有助于临床医师更为全面了解病灶的组织特征，为乳腺疾病的鉴别诊断提供了新途径。
Objective To investigate the value of shear wave elastography （SWE） in the diagnosis of benign and malig-nant breastlesions. Methods 208 female patients with breast lesions admitted to People＆#39;s Hospital of Maoming City from January 2012 to January 2014 were selected as the study objects, and all the patients obtained the SWE and breast imaging reporting and data system （BI-RASD） qualitative diagnosis. Compared the elastic modulus values of breast lesions, benign and malignant lesions, compared the elastic maximum, average values, and diagnosis efficiency of BI-RASD on the benign and malignant breast lesions. Results 176 benign lesions and 60 malignant lesions were diagnosed by the pathology. SWE imaging of breast fibroma, papillomatosis and breast disease showed uniform blue, and manifes-tations of inflammatory abscess were blue, the uncolored areas were not seen inside; invasion ductal carcinoma, inva-sive lobular carcinoma and intraductal carcinoma showed red as a main color with messy color, intraductal papillary carcinoma showed blue as a main color, and the red and the non colored section were seen interior. Elastic maximum and elastic average of malignant lesions were bigger than those of the benign lesions and breast gland tissue （P〈0.01）, benign lesions were greater than the mammary gland tissue （P〈 0.01）; there was no statistically significant difference in elastic minimum value between benign and malignant lesions （P〉0.05）, but greater than that of the mammary gland tissue （P〈0.01）. Compared elastic modulus maximum value in the diagnosis of the sensitivity, specificity and accuracy of breast diseases with BI-RASD classification, the differences were statistically significant （χ2=17.788, 26.072, 4.470, P=0.000, 0.000, 0.035）. Conclusion SWE has the advantages of simple operation, without pressure, and can directly show the elasticity value of the lesions. It can objectively quantitatively evaluate internal hardness of lesions, help the clinician understand organ
出处
《中国医药导报》
CAS
2015年第1期90-93,F0003,共5页
China Medical Herald
关键词
乳腺疾病
超声检查
剪切波弹性成像
鉴别诊断
Breast diseases
Ultrasonography
Shear wave elasticity imaging
Differential diagnosis
