超声弹性成像在鉴别诊断BI-RADS-US 4B级乳腺肿块中的价值评估

目的评价组织弹性成像技术在鉴别诊断BI-RADS-US 4B级乳腺肿块中的价值评估。方法用组织弹性成像技术对41名常规超声诊断为US BI-RADS 4B的患者进行乳腺肿块良恶性的鉴别诊断,并与术后的病理结果进行对照。结果乳腺良性和恶性肿块的组织弹性分级和面积比有显著性差异,利用弹性分级和面积比对乳腺肿块的良恶性鉴别诊断的灵敏度和特异度分别为75%(9/12)和86.21%(25/29)。结论常规超声如结合组织弹性成像技术,可有效提高US BI-RADS 4B级乳腺肿块的良恶性鉴别诊断准确性。     

超声弹性成像鉴别乳腺微小良恶性肿块

目的 评价超声弹性成像在乳腺微小良恶性肿块(≤10 mm)鉴别诊断中的价值.方法 对68例患者的87个乳腺肿块进行超声弹性成像评分,并与术后的病理结果进行对照.结果 超声弹性成像技术诊断恶性乳腺微小肿块的敏感度、特异度和准确率分别为84.00%(21/25)、96.77 %(60/62)和93.10%(81/87).结论 超声弹性成像对鉴别乳腺微小肿块的良恶性具有较高的临床价值.     

实时组织弹性成像技术在鉴别诊断乳腺良恶性肿块中的价值评估

目的评价组织弹性成像技术在鉴别诊断乳腺良、恶性肿块中的价值。方法用组织弹性成像技术对110例患者的115个乳腺肿块进行良、恶性的鉴别诊断，并与术后的病理结果进行对照。结果组织弹性成像技术对乳腺肿块良、恶性鉴别诊断的准确性、灵敏性和特异性分别为84．3％（97／115）、78.8％（26／33）和86.6％（71／82）。结论组织弹性成像为超声鉴别诊断良、恶性乳腺肿块提供了一个新的手段，尤其在一些边界不清、形态不规则病灶的良、恶性鉴别诊断中具有较高的临床应用价值。     

超声弹性成像技术鉴别乳腺肿块良恶性应用价值分析

目的探讨超声弹性成像技术对女性乳腺肿块良恶性的诊断价值。方法收集自2008年1月至2010年1月期间因乳腺肿块就诊于我院的420例患者的临床资料,并进行回顾性分析。所有患者均采用5分法对肿块的弹性硬度进行半定量分析,测量并记录肿块硬度、灰阶模式与弹性模式下的面积比,通过两种成像模式下所获面积比值的分析,得到肿块良恶性的最佳鉴别点,并对超声弹性成像技术在诊断乳腺良恶性肿块方面的灵敏度、特意度及准确率进行统计。结果乳腺肿块恶性鉴别的灵敏度、特异度及准确率分别为77.5%、91.1%、86.9%。运用两种成像模式下的图像面积比值对乳腺肿块良恶性鉴别时所获得的最佳诊断界点为1.8。结论超声弹性成像技术对乳腺恶性肿块的检查具有较高的检出率,与病理诊断的吻合度高。超声弹性成像技术对女性乳腺恶性肿块的诊断具重要价值。     

彩色多普勒超声联合弹性成像在乳腺肿块鉴别诊断中的应用价值

目的 探讨彩色多普勒超声联合实时组织弹性成像技术在鉴别乳腺良恶性肿块中的应用价值.方法 分别运用彩色多普勒超声和弹性成像技术检查352个乳腺肿块,与术后病理诊断结果进行对照,分析其超声征象、弹性成像评分以及二者联合应用诊断乳腺肿块良恶性的敏感性、特异性及准确性.结果 彩色多普勒超声、弹性成像及二者联合运用诊断乳腺肿块良恶性的敏感性为81.0％、79.3％及94.8％,特异性为85.4％、88.8％及95.6％,准确性为84.1％、87.2％及95.5％.彩色多普勒超声联合弹性成像的敏感性、特异性及准确性均高于二者单独应用(P＜0.05).结论 彩色多普勒超声联合弹性成像技术有助于鉴别乳腺肿块的良恶性,弹性成像技术是常规超声的有益补充.     

常规超声结合弹性成像对乳腺肿块良恶性的鉴别诊断价值

目的探讨常规超声结合弹性成像对乳腺肿块良恶性的鉴别诊断价值。方法 98例乳腺肿块患者共106个肿块,其中良性60个,恶性46个;术前行常规超声和弹性成像检查,并与术后病理结果对照。结果乳腺良性肿块弹性评分1~3分53例,占88.33%,平均(1.95±1.06)分;恶性肿块弹性评分4~5分35例,占76.09%,平均(4.02±0.95)分,两者差异有统计学意义(P0.05)。以弹性评分≥4分为界点,常规超声联合弹性成像诊断乳腺恶性肿块的敏感性、特异性、准确性分别为93.48%、88.33%、90.57%;联合应用诊断乳腺肿块良恶性的敏感性、准确性高于单独应用常规超声和弹性评分法(均P0.05),三者诊断特异性差异无统计学意义。结论乳腺良恶性肿块弹性评分分布情况各有特点,超声弹性成像联合常规超声能提高对乳腺肿块良恶性的鉴别诊断能力。     

弹性成像对乳腺良恶性肿物鉴别诊断价值

目的:探讨弹性成像对乳腺良恶性肿物鉴别诊断价值。方法:采用回顾性方法分析我院自2016年6月—2019年6月收治的89例乳腺肿瘤患者的临床资料,所有患者均给予超声弹性成像诊断,并以手术病理诊断为金标准,进行对比,分析乳腺良恶性肿瘤的弹性成像评分及敏感性、特异性及准确性。结果:恶性的弹性成像评分与良性肿块的弹性评分分布经对比分析,有显著差异(P<0.05)。弹性成像技术诊断乳腺癌良恶性肿瘤的敏感性92.42%(61/66)、特异性91.30%(21/23)、准确性92.13%(82/89)。结论:超声弹性成像可准确鉴别乳腺良恶性肿物,为临床治疗提供参考依据,值得推广应用。     

超声弹性成像对浅表软组织良恶性肿块的鉴别诊断价值

目的 探讨超声弹性成像对浅表软组织良恶性肿块的鉴别诊断价值.方法 应用超声弹性成像技术对48例患者共67个浅表软组织肿块进行检查,对弹性图进行分析并分级,将弹性图分级结果 与手术病理结果 作对比.结果 浅表软组织良性肿块的弹性分级以0～Ⅱ级多见,而恶性肿块的弹性分级以Ⅲ～Ⅳ级多见,良恶性肿块之间弹性分级的差异有统计学意义(P＜0.05).以Ⅲ级作为鉴别浅表软组织良恶性肿块的诊断界点,超声弹性成像鉴别诊断浅表软组织良恶性肿块的敏感性、特异性和准确性分别为85.71%、86.96%和86.57%.结论超声弹性成像为鉴别诊断浅表软组织良恶性肿块提供了一个新的方法 ,有助于浅表软组织肿块良恶性的鉴别.     

超声弹性成像与彩色多普勒超声在乳腺占位性病变诊断中的对比研究

目的 比较超声弹性成像超声(UE)与彩色多普勒超声(CDFI)在乳腺占位性病变鉴别诊断中的应用价值.方法 对93例,100个乳腺占位性病灶术前行彩色多普勒和超声弹性成像检查,以手术病理为金标准,对比分析彩色多普勒超声和超声弹性成像诊断乳腺肿块良恶性的准确度.结果 超声弹性成像(UE)诊断乳腺恶性病灶的敏感度90.2%,特异度93.9%,准确度92.0%,彩色多普勒超声中根据肿块内血流情况(对显示最多血管条数的肿块超声切面进行评价)参照Adler分级诊断乳腺恶性病灶的敏感度64.7%,特异度77.5%,准确度71.0%,脉冲多普勒中根据血流的阻力指数(RI)诊断乳腺恶性病灶的敏感度74.5%,特异度71.4%,准确度73.0%.联合彩色多普勒和脉冲多普勒诊断乳腺恶性病灶的灵敏度为50.9%,特异度为89.7%,准确度为70%.结论 超声弹性成像在鉴别诊断乳腺占位性病变良恶性中的准确度高于彩色多普勒超声.     

BI-RADS-US与弹性成像应变率比值对乳腺肿块的诊断价值

目的:比较BI-RADS-US诊断标准与弹性成像应变率比值对乳腺良恶性肿块的诊断价值.方法:对经手术病理证实的140例患者共159个肿块进行常规超声检查并按照BI-RADS-US标准诊断分级,再进行超声弹性成像检查,测定肿块与周围组织的弹性应变率比值,以弹性应变率比值≥3.08为界点判断肿块良恶性,以病理诊断结果为金标准,对比分析两种方法诊断乳腺肿块良恶性的准确度;构建受试者工作特征(ROC)曲线,比较两种方法对乳腺肿块的诊断效率.结果:良性78例共88个肿块,恶性62例共71个肿块,BI-RADS-US诊断乳腺良恶性病变的敏感性为91.55％(65/71),特异性为73.86％ (65/88),准确性为81.76％(130/159);弹性应变率比值诊断乳腺良恶性病变敏感性为94.37％ (67/71),特异性为87.50％(77/88),准确性为90.56％(144/159).构建ROC曲线后,两种方法的曲线下面积(AUC)分别为:BI-RADS-US诊断0.851,95％可信区间0.791～0.911;应变率比值诊断0.887,95％可信区间0.825～0.950.两种方法准确性的配对卡方McNemar检验结果P＜0.05,差异具有统计学意义.结论:超声弹性成像应变率比值测定鉴别乳腺良恶性肿块较BI-RADS-US诊断分级准确性高,对于BI-RADS-USⅣ级肿块更具诊断价值.     

超声弹性成像对乳腺实性肿瘤的初步研究

目的评价超声弹性成像新技术对乳腺实性肿瘤定性诊断的意义。方法对2005年3月～2005年5月34例（共37个病灶）乳腺实性肿瘤患者进行超声扫查，同时进行弹性成像。对照术后病理结果回顾性分析乳腺实性肿瘤超声弹性成像的特点。结果（1）乳腺癌弹性成像评分多为4、5分，纤维腺瘤多为1、2分，评分分布具有极其显著的统计学意义（P〈0．001）；（2）超声弹性成像中乳腺癌病灶前方出现较宽红晕，纤维腺瘤红晕较细，部分沿着包膜分布。红晕宽度在乳腺癌和纤维腺瘤两组病例中具有统计学意义（P〈0．001），可以作为乳腺良恶性肿瘤鉴别的要点之一。结论超声弹性成像在乳腺实性肿瘤的诊断中具有独特优势和广阔的应用前景。     

Diagnostic Performance of Elastography in Malignant Soft Tissue Tumors: A Systematic Review and Meta-analysis

Malignant soft tissue tumors (STTs) are often mistaken for benign tumors, leading to inappropriate treatment including unplanned resection. Elastography, as a non-invasive measurement of tissue mechanical properties, makes use of the different soft tissue elasticity in diverse pathologies to generate information that can be used for diagnostic purposes. Elastography for STTs carries important information that is helpful in differentiating malignant and benign masses. The present study was undertaken to systematically review existing trials on the reliability of elastography in assessment of malignant STTs. A comprehensive literature exploration of the PubMed, EMbase and China National Knowledge Infrastructure databases was conducted for published articles involving the application of elastography in distinguishing malignant STTs. The diagnostic performance of elastography was evaluated with pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio and area under the summary receiver operating characteristic curve. Publication bias was also evaluated. This meta-analysis enrolled 18 eligible studies with a total of 1420 patients. The overall number of reported STTs was 1569, of which 478 were classified as positive and 1091 as negative at elastography. The pooled sensitivity, specificity, positive likelihood ratio and negative likelihood ratio of elastography were 0.82 (95% confidence interval: 0.74–0.87), 0.80 (0.71–0.86), 3.99 (2.65-6.01) and 0.23 (0.15–0.34), respectively. The diagnostic odds ratio and area under the curve were 17.36 (8.28–36.38) and 0.88 (0.84–0.90), respectively (Glas et al. 2003). The results of meta-regression analysis revealed that the total number of patients and prevalence of malignant STTs were significant factors in sensitivity, and the year of publication, total number of patients and index test were significant factors affecting study heterogeneity for specificity (p < 0.05). No significant publication bias was observed. This meta-analysis indicates that ultrasound elastography achieves relatively good performance in discriminating between malignant and benign STTs. Nevertheless, further research is needed to verify this finding.     

Real-time elastography--an advanced method of ultrasound: First results in 108 patients with breast lesions.

OBJECTIVES: To evaluate whether real-time elastography, a new, non-invasive method for the diagnosis of breast cancer, improves the differentiation and characterization of benign and malignant breast lesions. METHODS: Real-time elastography was carried out in 108 potential breast tumor patients with cytologically or histologically confirmed focal breast lesions (59 benign, 49 malignant; median age, 53.9 years; range, 16-84 years). Tumor and healthy tissue were differentiated by measurement of elasticity based on the correlation between tissue properties and elasticity modulus. Evaluation was performed using the three-dimensional (3D) finite element method, in which the information is color-coded and superimposed on the B-mode ultrasound image. A second observer evaluated the elastography images, in order to improve the objectivity of the method. The results of B-mode scan and elastography were compared with those of histology and previous sonographic findings. Sensitivities and specificities were calculated, taking histology as the gold standard. RESULTS: B-mode ultrasound had a sensitivity of 91.8% and a specificity of 78%, compared with sensitivities of 77.6% and 79.6% and specificities of 91.5% and 84.7%, respectively, for the two observers evaluating elastography. Agreement between B-mode ultrasound and elastography was good, yielding a weighted kappa of 0.67. CONCLUSIONS: Our initial clinical results suggest that real-time elastography improves the specificity of breast lesion diagnosis and is a promising new approach for the diagnosis of breast cancer. Elastography provides additional information for differentiating malignant BI-RADS (breast imaging reporting and data system) category IV lesions.     

实时超声弹性成像临床应用122例分析

目的:探讨实时超声弹性成像real-time ultrasound elastography(RTE)在鉴别甲状腺结节、肝局灶性病变及乳腺结节良恶性上应用价值。材料与方法:对我院122例(172个结节)病灶进行常规超声及弹性超声检查,其中甲状腺疾病患者40例(44个结节),肝脏疾病患者36例(41个结节),乳腺疾病患者46例(87个结节),结果与病理对照。结果:如弹性评分大于III级及以上诊断,甲状腺恶性结节的灵敏度为100%,特异度为77.1%,准确度81.8%;肝脏恶性结节的灵敏度80%,特异度100%,准确度85.3%;乳腺恶性结节的灵敏度87%,特异度94%,准确度92%。良恶性结节的弹性图像分级差异有统计学差异(P0.05)。结论:RTE在甲状腺良恶性结节,肝脏局灶性病变,乳腺良恶性结节的鉴别诊断中具有较高的临床应用价值。     

Breast tumor classification using fuzzy clustering for breast elastography

Elastography is a new ultrasound imaging technique to provide the information about relative tissue stiffness. The elasticity information provided by this dynamic imaging method has proven to be helpful in distinguishing benign and malignant breast tumors. In previous studies for computer-aided diagnosis (CAD), the tumor contour was manually segmented and each pixel in the elastogram was classified into hard or soft tissue using the simple thresholding technique. In this paper, the tumor contour was automatically segmented by the level set method to provide more objective and reliable tumor contour for CAD. Moreover, the elasticity of each pixel inside each tumor was classified by the fuzzy c-means clustering technique to obtain a more precise diagnostic result. The test elastography database included 66 benign and 31 malignant biopsy-proven tumors. In the experiments, the accuracy, sensitivity, specificity and the area index Az under the receiver operating characteristic curve for the classification of solid breast masses were 83.5% (81/97), 83.9% (26/31), 83.3% (55/66) and 0.902 for the fuzzy c-means clustering method, respectively, and 59.8% (58/97), 96.8% (30/31), 42.4% (28/66) and 0.818 for the conventional thresholding method, respectively. The differences of accuracy, specificity and Az value were statistically significant (p < 0.05). We conclude that the proposed method has the potential to provide a CAD tool to help physicians to more reliably and objectively diagnose breast tumors using elastography.(E-mail: rfchang@csie.ntu.edu.tw)     

超声弹性成像与钼靶X线成像诊断乳腺疾病的对照研究

目的 探讨超声弹性成像(UE)与钼靶X线成像(MX-rP)诊断乳腺疾病的价值.方法 对80例女性患者共105个病灶术前行UE与MX-rP检查,以手术病理为诊断金标准,对比分析UE与MX-rP诊断乳腺疾病的准确性.结果 病理诊断良性59例(共79个病灶),恶性21例(共26个病灶).UE诊断乳腺恶性病变的敏感性、特异性和准确性分别为88.5%、96.2%、94.3%.MX-rP诊断乳腺恶性病变的敏感性、特异性和准确性分别为69.2%、92.4%、86.7%.UE诊断准确性高于MX-rP(P＜0.05).结论 UE诊断乳腺病变的准确性高于MX-rP,两者结合可提高乳腺良恶性病变诊断的准确性.     

声触诊组织量化和弹性成像技术评价乳腺良、恶性肿瘤

目的探讨声触诊组织量化(VTQ)和弹性成像技术诊断乳腺良、恶性肿瘤的价值。方法对86例乳腺病变患者术前分别进行常规超声、弹性超声及VTQ检查,对各病灶进行弹性成像评分和VTQ速度分组,并与病理结果对照。结果乳腺良、恶性肿瘤弹性超声评分差异有统计学意义(P<0.05),良性肿瘤中弹性超声评分为1～3分者占为68.09%(32/47),恶性肿瘤中弹性超声4～5分者占82.05%(32/39)。乳腺良、恶性肿瘤的VTQ速度值差异亦有统计学意义(P<0.05)。常规超声、弹性超声、VTQ技术联合应用的诊断准确率达91.86%。结论联合应用常规超声、弹性成像、VTQ技术,可显著提高诊断乳腺良、恶性肿瘤的准确率。     

经阴道超声弹性成像对宫颈癌诊断的临床应用初探

目的 探讨实时经阴道超声弹性成像在宫颈病变诊断中的临床应用价值.方法 分析124例宫颈病变患者的超声弹性图像,所有病例均经手术或组织活检病理证实.计算病变区与周围组织的弹性应变比值(strain ratio),以病理结果为金标准进行良恶性病变比较,采用ROC曲线分析strain ratio在诊断宫颈病变中的最佳截断值.结果 良性病变的弹性图像以绿色渲染为主,平均strain ratio值为2.71±1.56;恶性病变者渲染为蓝色,平均strain ratio为8.32±4.11,二者差异有统计学意义(P＜0.01).ROC 曲线显示当选取strain ratio为4.99时,曲线下面积最大达0.912,特异性和灵敏性分别为80.7％和89.6％.结论 实时超声弹性成像为宫颈病变良、恶性的鉴别诊断提供了一种新的无创检查方法.