| 李涛,何广敏,刘观成,罗春月.剪切波弹性成像鉴别乳腺影像报告和数据系统(BI-RADS)4类乳腺肿块[J].中国医学影像技术,2021,37(1):67~70 |
| 剪切波弹性成像鉴别乳腺影像报告和数据系统(BI-RADS)4类乳腺肿块 |
| Shear wave elastography parameters for differentiating breast imaging reporting and data system (BI-RADS) 4 breast masses |
| 投稿时间：2019-10-09 修订日期：2020-06-21 |
| DOI：10.13929/j.issn.1003-3289.2021.01.015 |
| 中文关键词: 乳腺肿瘤 超声检查 弹性成像技术 诊断,鉴别 |
| 英文关键词:breast neoplasms ultrasonography elasticity imaging techniques diagnosis, differential |
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| 中文摘要: |
| 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（SWEmax）、最小值（SWEmin）和平均值（SWEmean）；以受试者工作特征（ROC）曲线确定SWEmax、SWEmin及SWEmean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SWEmax和SWEmean均低于恶性组（P均<0.01），组间SWEmin差异无统计学意义（P>0.05）；SWEmax、SWEmean的AUC分别为0.86、0.83，均高于SWEmin的AUC （0.59，P均<0.01）；SWEmax诊断敏感度、特异度和准确率分别为96.23%、81.40%和89.58%，SWEmean分别为94.34%、76.74%和86.46%，均明显高于SWEmin的34.00%、37.21%和35.42%（P均<0.01）；SWEmax和SWEmean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）。SWEmax和SWEmean对BI-RADS 4a、4b及4c乳腺肿块的诊断准确率明显高于SWEmin（P<0.05）。结论 BI-RADS 4类乳腺恶性肿块的SWEmax和SWEmean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，SWEmax和SWEmean的诊断效能优于SWEmin。 |
| 英文摘要: |
| 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 (SWEmax), minimum elasticity (SWEmin) and mean elasticity (SWEmean) 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 SWEmax, SWEmin and SWEmean, 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 SWEmax and SWEmean of benign group were all lower than those of malignant group (both P<0.01), while SWEmin had no significant difference between groups (P>0.05). AUC of SWEmax was 0.86, of SWEmean was 0.83, all higher than that of SWEmin (0.59, both P<0.01). The sensitivity, specificity and accuracy of SWEmax was 96.22%,81.40% and 89.58%, of SWEmean was 94.34%, 76.74% and 86.46%, respectively, evidently higher than those of SWEmin (34.00%, 37.21% and 35.42%, all P<0.01). No significant difference of AUC, sensitivity, specificity nor accuracy of SWEmax and SWEmean was detected for differentiate benign and malignant BI-RADS 4 beast masses. The diagnostic accuracy of SWEmax and SWEmean to BI-RADS 4a, 4b and 4c lesions were all higher than those of SWEmin (all P<0.05). Conclusion Malignant BI-RADS 4 breast masses had higher SWEmax and SWEmean than benign ones. SWE of high frequency ultrasound could effectively differentiate benign and malignant BI-RADS 4 beast masses, and SWEmax and SWEmean showed better diagnostic efficiency than SWEmin. |
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