摘要
目的探讨剪切波弹性成像(SWE)鉴别乳腺影像报告和数据系统(BI-RADS)4类乳腺肿块的价值。方法回顾性分析经术后病理证实的96个BI-RADS 4类乳腺肿块,比较良性(良性组,n=43)及恶性肿块(恶性组,n=53)剪切波参数,包括弹性最大值(SWE max)、最小值(SWE min)和平均值(SWE mean);以受试者工作特征(ROC)曲线确定SWE max、SWE min及SWE mean的截断值,比较其ROC曲线下面积(AUC)、敏感度、特异度和准确率,评价并比较SWE对BI-RADS 4a、4b及4c亚分类的诊断准确率。结果良性组SWE max和SWE mean均低于恶性组(P均<0.01),组间SWE min差异无统计学意义(P>0.05);SWE max、SWE mean的AUC分别为0.86、0.83,均高于SWE min的AUC(0.59,P均<0.01);SWE max诊断敏感度、特异度和准确率分别为96.23%、81.40%和89.58%,SWE mean分别为94.34%、76.74%和86.46%,均明显高于SWE min的34.00%、37.21%和35.42%(P均<0.01);SWE max和SWE mean的AUC及其诊断BI-RADS 4类乳腺良恶性肿块的敏感度、特异度、准确率差异均无统计学意义(P均>0.05)。SWE max和SWE mean对BI-RADS 4a、4b及4c乳腺肿块的诊断准确率明显高于SWE min(P<0.05)。结论BI-RADS 4类乳腺恶性肿块的SWE max和SWE mean均高于良性肿块。高频超声SWE可有效鉴别BI-RADS 4类乳腺良恶性肿块,SWE max和SWE mean的诊断效能优于SWE min。
Objective To explore the value of shear wave elastography(SWE)for differentiating breast imaging reporting and data system(BI-RADS)4 breast masses.Methods A total of 96 BI-RADS 4 beast masses proved by postoperative pathology were retrospectively analyzed.The maximum elasticity(SWE max),minimum elasticity(SWE min)and mean elasticity(SWE mean)of SWE parameters were compared between the benign group(n=43)and the malignant group(n=53),and the receiver operating characteristic(ROC)curves were created to determine the cut-off values of SWE max,SWE min and SWE mean,the area under the curve(AUC)and the sensitivity,specificity,accuracy of these parameters as well as the diagnostic accuracy of SWE to BI-RADS 4a,4b and 4c lesions were compared.Results SWE max and SWE mean of benign group were all lower than those of malignant group(both P<0.01),while SWE min had no significant difference between groups(P>0.05).AUC of SWE max was 0.86,of SWE mean was 0.83,all higher than that of SWE min(0.59,both P<0.01).The sensitivity,specificity and accuracy of SWE max was 96.22%,81.40%and 89.58%,of SWE mean was 94.34%,76.74%and 86.46%,respectively,evidently higher than those of SWE min(34.00%,37.21%and 35.42%,all P<0.01).No significant difference of AUC,sensitivity,specificity nor accuracy of SWE max and SWE mean was detected for differentiate benign and malignant BI-RADS 4 beast masses.The diagnostic accuracy of SWE max and SWE mean to BI-RADS 4a,4b and 4c lesions were all higher than those of SWE min(all P<0.05).Conclusion Malignant BI-RADS 4 breast masses had higher SWE max and SWE mean than benign ones.SWE of high frequency ultrasound could effectively differentiate benign and malignant BI-RADS 4 beast masses,and SWE max and SWE mean showed better diagnostic efficiency than SWE min.
作者
李涛
何广敏
刘观成
罗春月
LI Tao;HE Guangmin;LIU Guancheng;LUO Chunyue(Department of Ultrasonic Imaging,Affiliated Cancer Hospital&Institute of Guangzhou Medical University,Guangzhou 510095,China)
出处
《中国医学影像技术》
CSCD
北大核心
2021年第1期67-70,共4页
Chinese Journal of Medical Imaging Technology
关键词
乳腺肿瘤
超声检查
弹性成像技术
诊断
鉴别
breast neoplasms
ultrasonography
elasticity imaging techniques
diagnosis,differential
