摘要
目的:探讨三维剪切波超声成像(3D-SWE)冠状面弹性定量参数鉴别乳腺结节性质的效能及其最佳截断值优化传统超声乳腺影像报告及数据系统(BI-RADS)分类的临床应用价值。方法:对2019年6月—2020年2月我院乳腺外科住院患者163例共184个乳腺结节在术前行传统超声及3D-SWE检查。以病理诊断为金标准,以3D-SWE冠状面具有最高受试者操作特征曲线(ROC)下面积(AUC)的弹性参数优化传统超声BI-RADS分类,并比较优化前后的诊断效能。结果:乳腺恶性结节组3D-SWE冠状面弹性模量值Emax、Emean和Eratio均高于良性结节组(P均<0.001);Emax(AUC 0.939)具有最优的诊断效能,以其最佳截断值(92.1 kPa)优化传统BI-RADS分类。优化前后两种BI-RADS分类良恶性最佳分界点均为4A~4B;优化后与优化前比较,AUC明显增加(0.913 vs 0.843,P=0.012),诊断恶性结节的特异度(91.9%vs 63.6%,P<0.001)及准确度(89.5%vs75.4%,P<0.001)均显著提高,敏感度(87.1%vs 87.1%,P=1.000)无变化。结论:3D-SWE冠状面Emax最佳截断值可有效优化传统的BI-RADS分类,显著提高鉴别诊断乳腺结节性质的精准性,使临床治疗有的放矢。
Objective:To explore the efficacy of three-dimensional shear wave elastography(3D-SWE)in the differential diagnosis of the nature of breast nodules with coronal plane elastic quantitative parameters,and the clinical application value of its optimal cut-off value to optimize the classification of traditional breast imaging reporting and data system(BI-RADS).Methods:A total of 184 breast nodules of 163 inpatients at the Department of Breast Surgery of Dalian Municipal Central Hospital from June 2019 to February 2020 were examined by traditional ultrasonography and 3D-SWE.Pathological diagnosis was taken as the gold standard,the elastic parameter of 3D-SWE coronal plane with the highest area under curve(AUC)according to receiver-operating characteristic(ROC)was used to optimize the classification of traditional BI-RADS,and the diag-nostic efficacy before and after optimization was compared.Result:The elastic values of Emax,Emean and Eratio of 3D-SWE coronal plane were higher in the malignant nodule group than those in the benign nodule group(all P<0.001).Emax(AUC0.939)showed the optimal diagnostic efficiency,and adjusted the classification of BI-RADS with its optimal cut-off value(92.1k Pa).Before and after optimization,the optimal cut-off value of the two BI-RADS classifications on benign and malignant nodules were all 4A~4B.Compared with before optimization,the AUC was obviously increased(0.913 vs 0.843,P=0.012),the specificity(91.9%vs 63.6%,P<0.001)and the accuracy(89.5%vs 75.4%,P<0.001)were significantly improved,and the sensitivity(87.1%vs 87.1%,P=1.000)was not changed.Conclusions:The optimal cut-off value of Emax on 3D-SWE coronal plane could effectively optimize the traditional BI-RADS classification,and significantly improve the accuracy and precision of differentiation between benign and malignant breast nodules.
作者
刘琳
曹秀群
张博
张海青
孟磊
赵俊军
潘晓芳
LIU Lin;CAO Xiu-qun;ZHANG Bo;ZHANG Hai-qing;MENG Lei;ZHAO Jun-jun;PAN Xiao-fang(Dalian Municipal Central Hospital Affiliated to Dalian Medical University,Dalian Limning 116033,China)
出处
《中国临床医学影像杂志》
CAS
CSCD
2022年第3期176-178,188,共4页
Journal of China Clinic Medical Imaging
关键词
乳腺肿瘤
纤维腺瘤
超声检查
乳房
Breast Neoplasms
Fibroadenoma
Ultrasonography
Mammary
