| 张威,王博,李晶,汪雪娇,丛瑞,任卫东.剪切波弹性成像定性技术鉴别诊断乳腺良恶性病变[J].中国医学影像技术,2016,32(7):1060~1064 |
| 剪切波弹性成像定性技术鉴别诊断乳腺良恶性病变 |
| Qualitative shear wave elastography in differential diagnosis of benign and malignant breast masses |
| 投稿时间：2015-08-05 修订日期：2015-10-27 |
| DOI：10.13929/j.1003-3289.2016.07.019 |
| 中文关键词: 乳腺肿瘤 超声检查 弹性成像技术 诊断显像 |
| 英文关键词:Breast neoplasms Utrasonography Elasticity imaging techniques Diagnositic imaging |
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| 中文摘要: |
| 目的 探讨SWE定性技术在乳腺病灶良恶性鉴别诊断中的应用价值。方法 对236例患者共261个病灶行常规超声及SWE检查。以常规超声图像进行乳腺影像报告和数据系统（BI-RADS）分类，将SWE图像分为6种类型。以病理结果为金标准，绘制ROC曲线，评价SWE分型、BI-RADS分类及二者联合的诊断效能。结果 良性病灶100个，恶性病灶161个。以SWE分型3型为诊断界点，敏感度、特异度、准确率、阳性预测值、阴性预测值分别为85.71%（138/161）、93.00%（93/100）、88.51%（231/261）、95.17%（138/145）、80.17%（93/116）；以BI-RADS 4a类为诊断界点，敏感度、特异度、准确率、阳性预测值、阴性预测值分别为98.76%（159/161）、73.00%（73/100）、88.89%（232/261）、85.48%（159/186）、97.33%（73/75）；二者联合诊断的敏感度、特异度、准确率、阳性预测值、阴性预测值分别为99.38%（160/161）、70.00%（70/100）、88.12%（230/261）、84.21%（160/190）、98.59%（70/71）。SWE分型的特异度和阳性预测值均高于BI-RADS分类及联合诊断（P均<0.05），BI-RADS分类及联合诊断的敏感度和阴性预测值均高于SWE分型（P均<0.05），三者诊断准确率差异均无统计学意义（P均>0.05）。结论 SWE定性技术有助于乳腺良恶性病灶的鉴别诊断。 |
| 英文摘要: |
| Objective To evaluate the value of qualitative shear wave elastography (SWE) in differential diagnosis of benign and malignant breast masses. Methods Totally 236 patients (261 breast masses) underwent conventional ultrasound and SWE examines. Images of conventional ultrasound were classified according to breast imaging reporting and data system (BI-RADS). And images of SWE were classified to six patterns. With the pathologic results as gold standard, ROC curves for SWE pattern, BI-RADS classification and the combination of SWE with BI-RADS were analyzed to evaluate the diagnostic efficacy. Results There were 100 benign masses and 161 malignant masses. With pattern 3 as optimal cut-off value of SWE, the sensitivity, specificity, accuracy, positive predictive value and negative predictive value was 85.71% (138/161), 93.00% (93/100), 88.51% (231/261), 95.17% (138/145), 80.17% (93/116), respectively. With BI-RADS classification 4a as optimal cut-off value of conventional ultrasound, the sensitivity, specificity, accuracy, positive predictive value and negative predictive value was 98.76% (159/161), 73.00% (73/100), 88.89% (232/261), 85.48% (159/186), 97.33% (73/75), respectively. For the combination of SWE with BI-RADS, the sensitivity, specificity, accuracy, positive predictive value and negative predictive value was 99.38% (160/161), 70.00% (70/100), 88.12% (230/261), 84.21% (160/190), 98.59% (70/71), respectively. The specificity and positive predictive value of SWE pattern were higher than those of BI-RADS classification and the combination of SWE with BI-RADS (all P<0.05). The sensitivity and negative predictive value of BI-RADS classification and the combination of SWE with BI-RADS were higher than those of SWE pattern. There was no significant difference of accuracy among SWE pattern, BI-RADS classification and the combination of SWE with BI-RADS. Conclusion Qualitative SWE is helpful for differential diagnosis of benign and malignant breast masses. |
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