摘要
目的:探讨剪切波弹性成像(shear wave elastography,SWE)联合超微血管显像(super microvascular imaging,SMI)在乳腺病灶良恶性鉴别诊断中的应用价值。方法:对236例乳腺占位性病变患者共272个病灶进行SWE及SMI检查。以手术后病理学检查结果为金标准,评价SWE、SMI及两者联合对乳腺病灶良恶性的鉴别诊断效能,并应用受试者工作特征(receiver operating characteristic,ROC)曲线分析SWE的最大值(E max)、平均值(E mean)、最小值(E min)、标准差(SD)以及病灶与周边正常组织比值(E ratio)对乳腺病灶良恶性的鉴别诊断价值。结果:272个病灶中,良性病灶125个,恶性病灶147个。恶性病灶的E max[(124.8±52.6)kPa vs(26.5±15.4)kPa]、E mean[(70.5±33.6)kPa vs(16.7±12.4)kPa]、E min[(27.3±16.2)kPa vs(9.1±5.8)kPa]、SD[(24.7±13.5)kPa vs(3.4±2.0)kPa]及E ratio(5.7±2.2 vs 1.4±0.5)明显高于良性病灶(P<0.01)。恶性病灶Alder血流分级Ⅱ~Ⅲ级者明显多于良性病灶(P<0.01)。SWE联合SMI鉴别诊断乳腺病灶良恶性的灵敏度、特异度及准确率分别为97.3%、94.4%、96.0%。E max、E mean、E min、SD及E ratio鉴别诊断乳腺病灶良恶性的曲线下面积(area under curve,AUC)分别为0.938、0.882、0.806、0.870、0.904,当E max取76.8 kPa时,其鉴别诊断乳腺病灶良恶性的灵敏度和特异度最好,分别为93.5%和91.8%。结论:E max对乳腺病灶良恶性鉴别诊断具有较高的价值,SWE联合SMI有助于提高乳腺病灶良恶性鉴别诊断的准确率。
Objective:To investigate the application value of shear wave elastography(SWE)combined with superb microvascular imaging(SMI)in differential diagnosis of benign and malignant breast lesions.Methods:SWE and SMI examinations were performed on 272 lesions in 236 patients with breast lesions.The diagnostic efficacy of SWE,SMI and their combination in differentiating benign from malignant breast lesions were evaluated based on the results of surgical pathology.The value of the maximum(E max),average(E mean),minimum(E min),standard deviation(SD)of SWE and the ratio of lesions to peripheral normal tissues(E ratio)in the differential diagnosis of benign and malignant breast lesions was analyzed by receiver operating characteristic(ROC)curve.Results:Among the 272 lesions,125 were benign and 147 were malignant.E max[(124.8±52.6)kPa vs(26.5±15.4)kPa],E mean[(70.5±33.6)kPa vs(16.7±12.4)kPa],E min[(27.3±16.2)kPa vs(9.1±5.8)kPa],SD[(24.7±13.5)kPa vs(3.4±2.0)kPa]and E ratio(5.7±2.2 vs 1.4±0.5)in malignant lesions were significantly higher than those in benign lesions(P<0.01).There were more cases of the Alder blood flowⅡ-Ⅲgrade in malignant lesions than that in benign lesions(P<0.01).The sensitivity,specificity and accuracy of SWE combined with SMI in differentiating benign and malignant breast lesions were 97.3%,94.4%and 96.0%,respectively.The area under curve(AUC)of E max,Emean,E min,SD and E ratio in differentiating benign and malignant breast lesions were 0.938,0.882,0.806,0.870 and 0.904,respectively.When E max was 76.8 kPa,the sensitivity and specificity of differentiating benign from malignant breast lesions were 93.5%and 91.8%,respectively.Conclusion:E max has higher value in differential diagnosis of benign and malignant breast lesions,and SWE combined with SMI can improve the accuracy of differential diagnosis.
作者
吕景
张娜
邸海燕
杨震
刘巍
白芳芳
Lü Jing;ZHANG Na;DI Haiyan;YANG Zhen;LIU Wei;BAI Fangfang(Department of Ultrasonography,Baoding Second Central Hospital,Zhuozhou 072750,Hebei Province,China)
出处
《肿瘤影像学》
2020年第5期448-452,共5页
Oncoradiology
关键词
剪切波弹性成像
超微血管显像
乳腺肿瘤
鉴别诊断
Shear wave elastography
Super microvascular imaging
Breast tumor
Differential diagnosis
