摘要
目的 探讨应变式弹性成像和剪切波弹性成像技术分别联合乳腺超声影像报告和数据系统(BI-RADS)对乳腺肿块性质良恶性的诊断价值。方法 回顾性分析2021年4月—2023年3月合肥市第二人民医院收治的105例乳腺肿块患者(共105个病灶)的临床病理资料,术前接受常规超声检查、应变式弹性成像和剪切波弹性成像检查。以病理结果为金标准将病灶分为良性组(64例)和恶性组(41例),比较2组弹性应变率比值(SR)、剪切波最大弹性模量值(Emax),绘制ROC曲线评估BI-RADS、SR、Emax及联合诊断恶性乳腺肿块的效能。结果 105例乳腺肿块患者经病理检查显示,共41例(39.05%)恶性肿块,64例(60.95%)良性肿块。BI-RADS分类结果显示,2类10例,3类16例,4a类21例,4b类19例,4c类18例,5类21例。以4b分类及以上诊断为恶性,BI-RADS分类诊断恶性乳腺肿块的灵敏度为92.68%,特异度为68.75%。恶性组SR、Emax值均高于良性组(P<0.05)。ROC曲线分析显示,SR、Emax诊断恶性乳腺肿块的AUC分别为0.739、0.784,最佳截断值分别为4.17%、98.21 kPa;SR+Emax联合诊断的AUC为0.861,灵敏度为70.73%,特异度为92.19%,约登指数为0.629,联合诊断效能高于单项诊断(P<0.05)。ROC曲线分析显示,SR+BI-RADS、Emax+BI-RADS、SR+Emax+BI-RADS诊断恶性乳腺肿块的AUC分别为0.826、0.830、0.892,SR+Emax+BI-RADS诊断效能高于SR+BI-RADS、Emax+BI-RADS、BI-RADS(P<0.05)。结论 SR+Emax+BI-RADS联合诊断能明显提高乳腺癌的诊断效能,提高了BI-RADS分类诊断的特异度。
Objective To investigate the diagnostic value of strain elastic imaging and shear wave elastic imaging combined with breast imaging reporting and data system(BI-RADS) in benign and malignant breast masses.Methods The clinicopathological data of 105 patients with breast masses(105 lesions in total) admitted to our hospital from April 2021 to March 2023 were reviewed.Preoperatively,they underwent routine ultrasonography,strain elastography,and shear wave elastography.The lesions were classified into benign and malignant groups using the pathological findings as the gold standard.Elastic strain ratio(SR),and shear wave maximum elastic modulus value(Emax) were compared between the two groups.The efficacy of BI-RADS,SR,Emax,and the combined diagnosis of malignancy of breast masses was evaluated by plotting the working characteristic ROC curves of the subjects.Results A total of 105 breast masses were examined pathologically showing 41(39.05%) malignant and 64(60.95%) benign masses.BI-RADS classification showed 10 cases in category 2,16 cases in category 3,21 cases in category 4a,19 cases in category 4b,18 cases in category 4c,and 21 cases in category 5.With a diagnosis of malignancy at 4b classification and above,the sensitivity of the BI-RADS classification for diagnosing malignant breast masses was 92.68% and the specificity was 68.75%.The SR and Emax values were higher in the malignant group than in the benign group(P<0.05).ROC curve analysis showed that the AUCs of SR and Emax for diagnosing malignant breast masses were 0.739 and 0.784,and the optimal cut-off values were 4.17% and 98.21 kPa,respectively,and the AUCs of SR+Emax combined diagnosis were 0.861,with a sensitivity of 70.73% and a specificity of 92.19%,and a Yoden index of 0.629,which showed that the efficacy of the combination was higher than that of the single diagnosis(P<0.05).ROC curve analysis showed that the AUCs of SR+BI-RADS,Emax+BI-RADS,and SR+Emax+BI-RADS for diagnosing malignant breast masses were 0.826,0.830,and 0.892,respectively,and the dia
作者
严立妹
葛宜兵
吴正升
YAN Limei;GE Yibing;WU Zhengsheng(Special Examination Department of Anhui Armed Police Corps Hospital,Hefei,Anhui 230001,China;不详)
出处
《中华全科医学》
2024年第3期473-477,共5页
Chinese Journal of General Practice
基金
安徽省自然科学基金项目(2008086ME213)。
