新型实时剪切波弹性成像对乳腺肿块良恶性的鉴别诊断价值

目的探讨实时剪切波弹性成像技术(SWE)诊断乳腺肿块的价值。方法选择50例乳腺肿块进行检查,分别测量剪切波速度(SWV)及杨氏模量值(EI),以病理结果为金标准,分析良恶性病灶之间弹性参数的差异。结果经病理检查证实乳腺肿块50个,包括乳腺恶性病灶27个,乳腺良性病灶23个。良性肿块剪切波传播图较规则,蓝色为主,颜色分布均匀,充填完整,而恶性肿块剪切波传播图波形变异大,以红色为主,颜色分布杂乱,具有典型的充填缺损特征。乳腺肿块良恶性病灶SWV平均值分别为(2.47±0.50)和(6.58±1.16)m/s,EI平均值分别为(18.30±8.59)和(112.40±27.3)k Pa,差异有显著性意义(PO.001)。绘制受试者操作特征(ROC)曲线得到剪切波速度值4.2 m/s、杨氏模量值50.0 k Pa为良恶性诊断最佳界点,诊断乳腺肿块良恶性的敏感度、特异度、准确度、阳性预测值、阴性预测值分别为85.2%、91.3%、88.0%、92.0%、84.0%。结论新型实时剪切波弹性成像技术对乳腺肿块良恶性的鉴别诊断有较好的应用价值。

Value of real-time shear wave elastography in the differential diagnosis of benign and malignant breast lesions

Objective To assess the clinical value of real-time shear wave elastography (SWE) in the differential diagnosis of benign and malignant breast lesions. Methods SWE of 50 breast masses before mastectomy was performed to obtain the internal transverse shear wave velocity (SWV) and elasticity index (EI). The elasticity parameters of pathologically confirmed benign and malig-nant lesions were retrospectively analyzed. Results In 23 benign lesions, the propagation picture of shear wave was uniform blue dis-tribution with complete filling. In 27 malignant lesions, the propagation picture of shear wave was irregular, mixed disorderly red distri-bution with typical filling defects. The average SWV and EI of benign (2.47±0.50 m/s, 18.30±8.59 kPa) were significantly (P<0.001) lower than that of malignant lesions (6.58±1.16 m/s, 112.4±27.3 kPa). At the optimal cut-off values of 4.2 m/s and 50.0 kPa on re-ceiver operating characteristic curves, the sensitivity, specificity, accuracy, positive predictive value and negative predictive value of SWE were 85.2%, 91.3%, 88.0%, 92.0%, and 84.0%, respectively. Conclusion SWE is valuable in the differential diagnosis of be-nign and malignant breast lesions.