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1.
Purpose
To compare the diagnostic performance of qualitative shear-wave elastography (SWE) according to three different color map opacities for breast massesMaterials and methods
101 patients aged 21–77 years with 113 breast masses underwent B-mode US and SWE under three different color map opacities (50%, 19% and 100%) before biopsy or surgery. Following SWE features were reviewed: visual pattern classification (pattern 1–4), color homogeneity (Ehomo) and six-point color score of maximum elasticity (Ecol). Combined with B-mode US and SWE, the likelihood of malignancy (LOM) was also scored. The area under the curve (AUC) was obtained by ROC curve analysis to assess the diagnostic performance under each color opacity.Results
A visual color pattern, Ehomo, Ecol and LOM scoring were significantly different between benign and malignant lesions under all color opacities (P < 0.001). For 50% opacity, AUCs of visual color pattern, Ecol, Ehomo and LOM scoring were 0.902, 0.951, 0.835 and 0.975. But, for each SWE feature, there was no significant difference in the AUC among three different color opacities. For all color opacities, visual color pattern and Ecol showed significantly higher AUC than Ehomo. In addition, a combined set of B-mode US and SWE showed significantly higher AUC than SWE alone for color patterns, Ehomo, but no significant difference was found in Ecol.Conclusion
Qualitative SWE was useful to differentiate benign from malignant breast lesion under all color opacities. The difference in color map opacity did not significantly influence diagnostic performance of SWE. 相似文献2.
Objective
To determine the correlation of qualitative shear wave elastography (SWE) pattern classification to quantitative SWE measurements and whether it is representative of quantitative SWE values with similar performances.Methods
From October 2012 to January 2013, 267 breast masses of 236 women (mean age: 45.12 ± 10.54 years, range: 21–88 years) who had undergone ultrasonography (US), SWE, and subsequent biopsy were included. US BI-RADS final assessment and qualitative and quantitative SWE measurements were recorded. Correlation between pattern classification and mean elasticity, maximum elasticity, elasticity ratio and standard deviation were evaluated. Diagnostic performances of grayscale US, SWE parameters, and US combined to SWE values were calculated and compared.Results
Of the 267 breast masses, 208 (77.9%) were benign and 59 (22.1%) were malignant. Pattern classifications significantly correlated with all quantitative SWE measurements, showing highest correlation with maximum elasticity, r = 0.721 (P < 0.001). Sensitivity was significantly decreased in US combined to SWE measurements to grayscale US: 69.5–89.8% to 100.0%, while specificity was significantly improved: 62.5–81.7% to 13.9% (P < 0.001). Area under the ROC curve (Az) did not show significant differences between grayscale US to US combined to SWE (P > 0.05).Conclusion
Pattern classification shows high correlation to maximum stiffness and may be representative of quantitative SWE values. When combined to grayscale US, SWE improves specificity of US. 相似文献3.
Aim of the work
To evaluate the value of real-time ultrasound elastography (RTE) in differentiating benign from malignant breast masses.Materials and methods
This study included, whether palpable or non-palpable, 145 sonographically proven breast masses in 121 patients, imaged by conventional B-mode US, color-flow Doppler US and RTE with histopathological analysis considered as the golden standard reference.Results
Lesions were differentiated into benign and malignant by conventional B-mode US (79; 45.5% and 66; 54.5%, respectively), RTE (80; 55.2% and 65; 44.8% respectively), and histopathology (82; 56.6% and 63; 43.4%, respectively). The mean difference in the mass size was significant between B-mode US and RTE in malignant masses (P = 0.002), while not significant among benign masses (P = 0.153). The B-mode US depicted sensitivity of 92.06%, specificity of 90.24%, PPV of 87.88%, NPV of 93.67% and accuracy of 91.03%, while the RTE showed sensitivity of 98.41%, specificity of 96.34%, PPV of 95.38%, NPV of 98.75% and accuracy of 97.24%.Conclusion
Combined use of RTE can complement conventional B-mode US with improving its diagnostic performance in differentiating breast lesions with subsequent reduction in the rate of unnecessary biopsies in benign lesions. 相似文献4.
Objective
The aim of work is to evaluate the role of magnetic resonance imaging in the assessment of different entities of inflammatory breast disorders.Materials and methods
Eighty-one non-lactating patients with mastitis had been evaluated by post contrast MR imaging; their ages ranged from 22 to 70 years (Average age: 41.6 years). MRI data analysis was performed regarding qualitative criteria and parametric color maps for image post processing. Diagnosis was made up regarding resolution in follow up sessions for simple mastitis and biopsy were done for cases with suspicious imaging findings.Results
Mammary interstitial edema with no masses or abnormal enhancement was elicited in 28.4% (n = 23/81). T2-weighed and post contrast series were the sequences of choice to rely upon in evaluation. T2 had demonstrated lesions in 64.2% (n = 52/81) and contrast uptake was detected in 68% (n = 55/81). Quantitative analysis was overlapping.MR imaging had displayed sensitivity, specificity and accuracy of 87.5%, 72.3%, and 75.4% respectively in differentiating benign forms of mastitis from malignant ones.Conclusion
In inflammatory breast disorders, MR imaging can precisely delineate disease extent and monitor response to therapy. Immediate distinction between infectious/non-infectious and malignant mastitis is difficult to be obtained. 相似文献5.
Victor Ianculescu Laura Maria Ciolovan Ariane Dunant Philippe Vielh Chafika Mazouni Suzette Delaloge Clarisse Dromain Alexandru Blidaru Corinne Balleyguier 《European journal of radiology》2014
Purpose
To determine the diagnostic performance of Acoustic Radiation Force Impulse (ARFI) Virtual Touch IQ shear wave elastography in the discrimination of benign and malignant breast lesions.Materials and methods
Conventional B-mode and elasticity imaging were used to evaluate 110 breast lesions. Elastographic assessment of breast tissue abnormalities was done using a shear wave based technique, Virtual Touch IQ (VTIQ), implemented on a Siemens Acuson S3000 ultrasound machine. Tissue mechanical properties were interpreted as two-dimensional qualitative and quantitative colour maps displaying relative shear wave velocity. Wave speed measurements in m/s were possible at operator defined regions of interest. The pathologic diagnosis was established on samples obtained by ultrasound guided core biopsy or fine needle aspiration.Results
BIRADS based B-mode evaluation of the 48 benign and 62 malignant lesions achieved 92% sensitivity and 62.5% specificity. Subsequently performed VTIQ elastography relying on visual interpretation of the colour overlay displaying relative shear wave velocities managed similar standalone diagnostic performance with 92% sensitivity and 64.6% specificity. Lesion and surrounding tissue shear wave speed values were calculated and a significant difference was found between the benign and malignant populations (Mann–Whitney U test, p < 0.0001). By selecting a lesion cut-off value of 3.31 m/s we achieved 80.4% sensitivity and 73% specificity. Applying this threshold only to BIRADS 4a masses, we reached overall levels of 92% sensitivity and 72.9% specificity.Conclusion
VTIQ qualitative and quantitative elastography has the potential to further characterise B-mode detected breast lesions, increasing specificity and reducing the number of unnecessary biopsies. 相似文献6.
Objective
To assess the diagnostic value of high-frequency (MicroPure) ultrasound in evaluating suspicious microcalcifications and to determine its capability in biopsy guidance.Subjects and methods
Sixty-two cases with suspicious microcalcifications detected on mammographic examination had been re-evaluated by MicroPure US. The studied cases underwent true cut tissue/surgical excision biopsy. Histopathology revealed 25 benign and 37 malignant lesions and was considered the gold standard of reference.Results
Malignant microcalcifications were easier to be visible at MicroPure US, as they were detected in 86.5% (n = 32/39) compared to only 68% (n = 17/25) of the benign lesions. US depicted more breast masses associated with malignant microcalcifications in 78% (n = 29/37) than those associated with benign ones seen in 36% (n = 9/25).Visibility of suspicious microcalcifications at US was aided by preliminary mammogram. Given known mammography location of these microcalcifications had made their visualization accessible by MicroPure US in 79% (n = 49) of the cases.Conclusion
MicroPure ultrasound cannot discriminate benign from malignant breast microcalcifications. MicroPure can be useful in detecting clustered microcalcifications that are not accessible by B-mode ultrasound; provided knowledge of their mammographic location and thus can provide better guidance for pre-surgical wire localization and ultrasound-guided biopsies. 相似文献7.
I. Thomassin-Naggara Pascale Siles I. Trop J. Chopier E. Darai M. Bazot S. Uzan 《European journal of radiology》2013
Objective
To compare the accuracy of different MR sequences to measure tumor size.Methods
Eighty-six women (mean age: 53 years (30–78)) who underwent preoperative MRI for breast cancer were included. Maximal diameters of the index tumor (IT) and of the whole extent of the tumor (WET) were measured on T2-weighted (T2W) sequences, on dynamic contrast-enhanced (DCE) T1-weighted (T1W) sequences and on Maximal Intensity Projection (MIP) reconstructions. Agreements with pathological size were evaluated using concordance correlation coefficient (k).Results
Median pathological size of IT was 20 mm (13–25 mm, interquartile range). Median pathological size of the WET was 29 mm (16–50 mm, interquartile range). Measurement of IT showed a good concordance with pathological size, with best results using T2W (k = 0.690) compared to MIP (k = 0.667), early-subtracted DCE frame (k = 0.630) and early-native DCE frame (k = 0.588). IT was visible on T2W in 83.7% and accurately measured within 5 mm in 69.9%. Measurement of WET was superior using early-subtracted DCE frame (k = 0.642) compared to late-native frame (k = 0.635), early-native frame (k = 0.631), late-subtracted frame (k = 0.620) and MIP (k = 0.565). However, even using early-subtracted frame, WET was accurately measured within 5 mm only 39.3%.Conclusion
If visible, IT size is best measured on T2W with a good accuracy (69%) whereas WET is best estimated on early-subtracted DCE frame. However, when adjacent additional sites exist around IT, suspected surrounding disease components need to be proved by pathological analysis. 相似文献8.
Evrim Özmen İbrahim Adaletli Yasemin Kayadibi Şenol Emre Fahrettin Kılıç Sergülen Dervişoğlu Sebuh Kuruğoğlu Osman Faruk Şenyüz 《European journal of radiology》2014
Objective
In children it is crucial to differentiate malignant liver tumors from the most common benign tumor, hepatic hemangiomas since the treatment strategies are quite different. We aimed to evaluate the efficiency of shear wave elastography (SWE) technique in differentiation of malignant hepatic tumors and hepatic hemangiomas.Methods
Twenty patients with hepatic tumor were included in our study. Two radiologists performed SWE for 13 patients with malignant hepatic tumors including hepatoblastoma (n = 7), hepatocellular carcinoma (n = 3), metastasis (n = 2), embryonal sarcoma (n = 1) and 7 patients with hepatic hemangioma. All of our patients were between the age of 1 and 192 months (mean age: 56.88 months). Receiver operating characteristic analysis was achieved to evaluate the diagnostic accuracy of SWE and to determine the optimal cut-off value in differentiation hepatic hemangioma from malignant hepatic tumors.Results
The mean SWE values (in kPa) for the first observer were 46.94 (13.8–145) and 22.38 (6.6–49.6) and those for the second observer were 57.91 (11–237) and 23.87 (6.4–57.5), respectively for malignant hepatic tumors and hepatic hemangiomas. The SWE values of malignant hepatic tumors were significantly higher than those of hepatic hemangioma (p = 0.02). The inter-observer agreement was almost perfect (0.81). The area under the receiver operating characteristic curve of SWE for differentiating the hepatic hemangioma from malignant hepatic tumors was 0.77 with a sensitivity of 72.7% and a specificity of 66.7% at a cutoff value of 23.62 with 95% confidence interval.Conclusion
Shear wave elastography can be helpful in differentiation of malignant hepatic tumors and hepatic hemangioma. 相似文献9.
Jost Karsten Kloth Marianne Winterstein Michael Akbar Esther Meyer Dominik Paul Haus-Ulrich Kauczor Marc-André Weber 《European journal of radiology》2014
Purpose
To determine the accuracy and reliability of three-dimensional (3D) T1- and proton density (PD)-weighted turbo spin-echo (TSE) sampling perfection with application-optimized contrasts using different flip-angle evolution (SPACE) compared with conventional 2D sequences in assessment of the shoulder-joint.Materials and methods
Ninety-three subjects were examined on a 3-T MRI system with both conventional 2D-TSE sequences in T1-, T2- and PD-weighting and 3D SPACE sequences in T1- and PD-weighting. All examinations were assessed independently by two reviewers for common pathologies of the shoulder-joint. Agreement between 2D- and 3D-sequences and inter-observer-agreement was evaluated using kappa-statistics.Results
Using conventional 2D TSE sequences as standard of reference, sensitivity, specificity, and accuracy values of 3D SPACE were 81.8%, 95.1%, and 93.5% for injuries of the supraspinatus-tendon (SSP), 81.3%, 93.5%, and 91.4% for the cartilage layer and 82.4%, 98.5%, and 97.5% for the long biceps tendon. Concordance between 2D and 3D was almost perfect for tendinopathies of the SSP (κ = 0.85), osteoarthritis (κ = 1), luxation of the biceps tendon (κ = 1) and adjacent bone marrow (κ = 0.92). Inter-observer-agreement was generally higher for conventional 2D TSE sequences (κ, 0.23–1.0), when compared to 3D SPACE sequences (κ, −0.33 to 1.0) except for disorders of the long biceps tendon and supraspinatus tendon rupture.Conclusion
Because of substantial and almost perfect concordance with conventional 2D TSE sequences for common shoulder pathologies, MRI examination-time can be reduced by nearly 40% (up to 11 min) using 3D-SPACE without loss of information. 相似文献10.
Ji Hyun Youk Hye Mi Gweon Eun Ju Son Kyung Hwa Han Jeong-Ah Kim 《European radiology》2013,23(10):2695-2704
Objectives
To evaluate the diagnostic performance of shear-wave elastography (SWE) for breast cancer and to determine whether the integration of SWE into BI-RADS with subcategories of category 4 improves the diagnostic performance.Methods
A total of 389 breast masses (malignant 120, benign 269) in 324 women who underwent SWE before ultrasound-guided core biopsy or surgery were included. The qualitative SWE feature was assessed using a four-colour overlay pattern. Quantitative elasticity values including the lesion-to-fat elasticity ratio (Eratio) were measured. Diagnostic performance of B-mode ultrasound, SWE, or their combined studies was compared using the area under the ROC curve (AUC).Results
AUC of Eratio (0.952) was the highest among elasticity values (mean, maximum, and minimum elasticity, 0.949, 0.939, and 0.928; P?=?0.04) and AUC of colour pattern was 0.947. AUC of combined studies was significantly higher than for a single study (P?<?0.0001). When adding SWE to category 4 lesions, lesions were dichotomised according to % of malignancy: 2.1 % vs. 43.2 % (category 4a) and 0 % vs. 100 % (category 4b) for Eratio and 2.4 % vs. 25.8 % (category 4a) for colour pattern (P?<?0.05).Conclusions
Shear-wave elastography showed a good diagnostic performance. Adding SWE features to BI-RADS improved the diagnostic performance and may be helpful to stratify category 4 lesions.Key points
? Quantitative and qualitative shear-wave elastography provides further diagnostic information during breast ultrasound. ? The elasticity ratio (E ratio ) showed the best diagnostic performance in SWE. ? E ratio and four-colour overlay pattern significantly differed between benign and malignant lesions. ? SWE features allowed further stratification of BI-RADS category 4 lesions. 相似文献11.
Ji Hyun Youk Hye Mi Gweon Eun Ju Son Jin Chung Jeong-Ah Kim Eun-kyung Kim 《European radiology》2013,23(6):1519-1527
Objectives
To evaluate the interobserver agreement and the diagnostic performance of 3D shear-wave elastography (SWE) for breast lesions in comparison with 2D SWE.Methods
A total of 163 breast lesions (malignant 48, benign 115) in 146 women who underwent B-mode ultrasound and SWE before biopsy were included. Two radiologists reviewed six data sets (B-mode, SWE, and a combination of both for 2D and 3D ultrasound). B-mode and SWE features were recorded. BI-RADS category was assigned for B-mode and combined sets. Interobserver variability was assessed using the κ statistic. Diagnostic performance of each data set was evaluated using the area under the ROC curve (AUC).Results
SWE showed substantial to almost perfect agreement, with Ehomo in 2D SWE being higher than in 3D SWE. The AUC of 2D SWE was higher than 3D SWE for all SWE features, significantly so for Ecol (0.933 vs. 0.867, P?=?0.002) and Emax (0.961 vs. 0.874, P?=?0.006). After adding SWE to B-mode ultrasound, the AUC in 2D ultrasound increased significantly (0.968 vs. 0.912, P?=?0.008), but 3D ultrasound showed no significant difference (0.966 vs. 0.935; P?=?0.07).Conclusion
For 3D SWE, interobserver agreement was good, but the diagnostic performance was inferior to 2D SWE even after adding to B-mode ultrasound.Key Points
? Shear-wave elastography (SWE) provides further diagnostic information during breast ultrasound. ? 3D SWE diagnostic performance is inferior to 2D SWE. ? In 3D SWE, interobserver agreement was good. ? 2D B-mode ultrasound showed significant diagnostic improvement when combined with 2D SWE. ? 3D B-mode ultrasound performance was not significantly improved when combined with 3D SWE. 相似文献12.
Marwa Abd El-hamied Romeih Ahmed Ebraheem Ebeed Islam M. Sabry 《The Egyptian Journal of Radiology and Nuclear Medicine》2018,49(2):553-563
Purpose
To assess the additional diagnostic value of share wave elastography in combination with B-mode ultrasound versus B-mode ultrasound alone in characterization of solid breast lesions.Patients and methods
prospective study included women with a single undiagnosed solid breast lesion, between May 2016 and May 2017. All patients underwent B-mode ultrasound and (SWE), and histopathology was performed on all lesions.Results
150 women included in this study. 87 breast lesions were malignant & 63 were benign. B-mode ultrasound was performed and the lesions were categorized according to the (BI-RADS). With a sensitivity of 89.7%, specificity of 76.2%, overall accuracy of 84%. Using SWE alone based on elasticity, speed and color pattern, the cut-off values were ≥46?kPa and ≥3.25?m/s. These values demonstrated a sensitivity of 96.6%, specificity of 90.47%, and overall accuracy of 94%. The color pattern had a better sensitivity of 96.8%, specificity of 92%, and overall accuracy of 94.5%.The combination of SWE and B-mode ultrasound results using logistic regression modeling improved diagnostic performance, with an overall accuracy of 96%.Conclusion
Combined B-mode ultrasound with shear-wave elastography will improve the overall diagnostic performance for the differentiation of benign and malignant breast lesions. 相似文献13.
Michael Golatta Mirjam Schweitzer-Martin Aba Harcos Sarah Schott Hans Junkermann Geraldine Rauch Christof Sohn Jörg Heil 《European journal of radiology》2013
Objective
To evaluate normal breast tissue stiffness with virtual touch tissue imaging quantification (VTIQ) using prospectively collected data.Materials and Methods
B-mode ultrasound and VTIQ were performed in 132 breasts in 97 women. Mean values of VTIQ for parenchyma and fatty tissue were compared between those measured in healthy breasts and in the surrounding of histologically proven benign and malignant breast lesions. Moreover we reviewed VTIQ values according to breast density measured by the American College of Radiology (ACR) categories. In addition we analyzed re-test reliability of VTIQ.Results
In 132 breasts the mean VTIQ values in parenchyma were significantly higher than in fatty tissue (3.23 m/s ± 0.74 versus 2.5 m/s ± 0.61; p < 0.0001). In healthy breasts as well as in the surrounding of a benign or malignant lesions the VTIQ values of parenchyma were similar (p = 0.12). In fatty tissue, small differences between mean VTIQ values of 2.25 m/s ± 0.51, 2.52 m/s ± 0.48 and 2.65 m/s ± 0.71 (p = 0.01) in the respective groups were observed. The comparison of mean VTIQ values of parenchyma and fatty tissue in more and less dense breasts (ACR 1 + 2 versus ACR 3 + 4 breasts) also yielded no statistically significant difference. The re-test reliability of VTIQ assessed with three independent measurements was moderate (interclass-correlation of 0.52 (p < 0.0001)).Conclusion
VTIQ is a reliable method for measuring the stiffness of breast tissue. We propose standard values for healthy parenchyma and fatty tissues independent of the surrounding tissue or the ACR category. 相似文献14.
Abdominal ultrasonography in preterm necrotizing enterocolitis. Is it superior to plain radiography?
Naglaa H. Shebrya Sherine K. AminMaha A. El-Shinnawy Safaa S. Imam 《The Egyptian Journal of Radiology and Nuclear Medicine》2012
Purpose
To explore whether abdominal ultrasound (AUS) provide additional information over plain radiography in cases of necrotizing enterocolitis (NEC).Methods
This study is a prospective study of 30 premature neonates with NEC in our neonatal intensive care unit between August 2010 and November 2011. Fifteen premature control neonates were also included in the study.Results
Patients were classified into two groups: the first group with suspected NEC (stage I) (n = 14) and the second with definite NEC (stage II or III) (n = 16). In group I abdominal ultrasound (AUS) revealed intramural air (n = 9) and portal venous gas (PVG) (n = 1) while plain radiography showed only gaseous distension. In group II, intramural air (n = 10), PVG (n = 2), free fluid (n = 6) focal fluid (n = 1) and free air (n = 6) detected by AUS compared to pneumatosis intestinalis (PI) (n = 2) PVG (n = 1) and free air (n = 5) by plain radiography. Additionally bowel wall thinning was detected in 2 neonates of group I and 3 of group II.Conclusion
Our results suggest AUS to be superior to plain radiography in early detection of complication as intestinal perforation by eliciting PVG and fluid collection and so early surgical management. Therefore this may decrease morbidity and mortality rates. 相似文献15.
Janice S. Sung Valencia King Cynthia M. Thornton Jennifer D. Brooks Charles W. Fry Mahmoud El-Tamer Lawrence T. Dauer Edi Brogi Jean M. St Germain Elizabeth A. Morris 《European journal of radiology》2013
Purpose
To evaluate the safety and efficacy of pre-operative I-125 radioactive seed localization (RSL) as an alternative to wire localization (WL).Methods
A waiver was granted by the institutional review board for this HIPAA compliant study. Review of 356 consecutive single site nonpalpable mammographic and ultrasound guided I-125 RSLs done between November 2011 and April 2012 was conducted. Preoperative mammograms and specimen radiographs were reviewed for seed-target distance, lesion location, and target/seed removal. During a brief surgical training period, 35 of 356 women had both RSL and wire localization (WL) of the same lesion. Chi-square and single sample t-tests were used to compare margin status and duration of procedures.Results
Of the 356 RSLs, 303 (85.1%) were performed ≥1 day before surgery. Mammographic guidance was used in 330 (93%) and ultrasound in 26 (7%). Mean seed to target distance was 1 mm (range 0–20 mm); all targeted lesions were retrieved. In 31 women in whom mammographic guidance was used for both RSL and WL, median procedure time was not significantly different (RSL 9.0 min; WL 7.0 min; p = 0.91), and median seed migration distance was <1 mm (range 0–15 mm). No difference was detected between margin status with RSL alone versus WL (p = 0.40 and p = 0.65 for positive and <1 mm margins, respectively). Two adverse events occurred requiring an additional wire/surgery.Conclusion
RSL ≥ 1 day before surgery is a safe effective procedure for pre-operative localization, with few adverse events and surgical outcomes comparable to those achieved with wire localization. 相似文献16.
Cosgrove DO Berg WA Doré CJ Skyba DM Henry JP Gay J Cohen-Bacrie C;BE Study Group 《European radiology》2012,22(5):1023-1032
Objectives
To evaluate intra- and interobserver reproducibility of shear wave elastography (SWE) for breast masses.Methods
For intraobserver reproducibility, each observer obtained three consecutive SWE images of 758 masses that were visible on ultrasound. 144 (19%) were malignant. Weighted kappa was used to assess the agreement of qualitative elastographic features; the reliability of quantitative measurements was assessed by intraclass correlation coefficients (ICC). For the interobserver reproducibility, a blinded observer reviewed images and agreement on features was determined.Results
Mean age was 50 years; mean mass size was 13 mm. Qualitatively, SWE images were at least reasonably similar for 666/758 (87.9%). Intraclass correlation for SWE diameter, area and perimeter was almost perfect (ICC?≥?0.94). Intraobserver reliability for maximum and mean elasticity was almost perfect (ICC?=?0.84 and 0.87) and was substantial for the ratio of mass-to-fat elasticity (ICC?=?0.77). Interobserver agreement was moderate for SWE homogeneity (κ?=?0.57), substantial for qualitative colour assessment of maximum elasticity (κ?=?0.66), fair for SWE shape (κ?=?0.40), fair for B-mode mass margins (κ?=?0.38), and moderate for B-mode mass shape (κ?=?0.58), orientation (κ?=?0.53) and BI-RADS assessment (κ?=?0.59).Conclusions
SWE is highly reproducible for assessing elastographic features of breast masses within and across observers. SWE interpretation is at least as consistent as that of BI-RADS ultrasound B-mode features.Key Points
? Shear wave ultrasound elastography can measure the stiffness of breast tissue ? It provides a qualitatively and quantitatively interpretable colour-coded map of tissue stiffness ? Intraobserver reproducibility of SWE is almost perfect while intraobserver reproducibility of SWE proved to be moderate to substantial ? The most reproducible SWE features between observers were SWE image homogeneity and maximum elasticity17.
Amani Ezzat Mousa Mohamed Aboelatta Khaled Zalata 《The Egyptian Journal of Radiology and Nuclear Medicine》2012
Aim of the work
To detect the diagnostic performance of the combined use of sonoelastographic scoring and strain ratio in differentiation of benign and malignant breast masses with the histopathology is the standard reference.Patients and methods
One hundred and seventy-two women with 190 breast masses were enrolled in this prospective study. Conventional US (B-mode and color Doppler US) and sonoelastography (elasticity score “ES” and calculation of strain ratio “SR”) were performed. B-mode images were classified according to the Breast Imaging Recording and Data System. The hardness was determined with 5-point scoring method and SRs of the lesions were calculated. Receiver operating characteristic (ROC) curves were performed and the cutoff point for differentiation of benign and malignant masses was detected.Results
There was a significant difference (P = 0.02) in the mean SRs between benign and malignant breast masses. The area under the curve (AUC) for combination of ES and SR (0.964) was higher than for ES alone (0.852) and B-mode US (0.823). A cutoff value of 3.6 for the SR allowed the best differentiation of benign and malignant breast lesions.Conclusion
The combined use of elasticity score and strain ratio of sonoelastography increased the diagnostic performance in distinguishing benign from malignant breast masses. 相似文献18.
Su Hyun Lee Jung Min Chang Won Hwa Kim Min Sun Bae Nariya Cho Ann Yi Hye Ryoung Koo Seung Ja Kim Jin You Kim Woo Kyung Moon 《European radiology》2013,23(4):1015-1026
Objectives
To prospectively compare the diagnostic performances of two-dimensional (2D) and three-dimensional (3D) shear-wave elastography (SWE) for differentiating benign from malignant breast masses.Methods
B-mode ultrasound and SWE were performed for 134 consecutive women with 144 breast masses before biopsy. Quantitative elasticity values (maximum and mean elasticity in the stiffest portion of mass, Emax and Emean; lesion-to-fat elasticity ratio, Erat) were measured with both 2D and 3D SWE. The area under the receiver operating characteristic curve (AUC), sensitivity and specificity of B-mode, 2D, 3D SWE and combined data of B-mode and SWE were compared.Results
Sixty-seven of the 144 breast masses (47 %) were malignant. Overall, higher elasticity values of 3D SWE than 2D SWE were noted for both benign and malignant masses. The AUC for 2D and 3D SWE were not significantly different: Emean, 0.938 vs 0.928; Emax, 0.939 vs 0.930; Erat, 0.907 vs 0.871. Either 2D or 3D SWE significantly improved the specificity of B-mode ultrasound from 29.9 % (23 of 77) up to 71.4 % (55 of 77) and 63.6 % (49 of 77) without a significant change in sensitivity.Conclusion
Two-dimensional and 3D SWE performed equally in distinguishing benign from malignant masses and both techniques improved the specificity of B-mode ultrasound.Key Points
? Shear-wave elastography (SWE) is increasingly used during ultrasound of the breast ? 2D and 3D SWE performed equally in distinguishing benign from malignant masses ? Either SWE method, combined with B-mode, outperformed B-mode ultrasound alone ? Quantitative elasticity was greater for 3D than 2D SWE for all masses 相似文献19.
Kristina I. Ringe Bastian P. Ringe Hüseyin Bektas Jan P. Opherk Angela Reichelt Joachim Lotz Frank Wacker Bernhard C. Meyer 《European journal of radiology》2012
Objective
To assess the value of gadoxetate disodium for characterization and staging of central bile duct stenosis (CBDS).Materials and methods
This prospective HIPAA-compliant study was IRB approved. 14 patients (8 male, 6 female; 36–80 years) with clinical suspicion of CBDS underwent preoperative MRI. To estimate the value of hepatocyte phase images (10, 20, 120 min p.i.), only T2w images (T2), only post-contrast images (CM), or both image datasets were assessed in three reading sessions by 3 readers. Agreement of each reading session with the intraoperative findings in terms of CBDS etiology and tumor extension (weighted kappa statistic) was calculated.Results
CBDS was caused by hilar cholangiocarcinoma (n = 9), gallbladder carcinoma (n = 4) and pancreatic carcinoma (n = 1). Characterization of CBDS etiology was correct by use of: T2w images in 57%, 64%, 50%; CM images in 64%, 57%, 50%; both in 71%, 64%, 64%. Agreement comparing reading sessions and intraoperative findings regarding tumor extension was fair up to moderate (κ-range = 0.21–0.54) as a result of common underestimation. Interobserver agreement for tumor extension was fair (κ-range = 0.31–0.33).Conclusions
By means of combined evaluation of T2 and CM images a more reliable characterization of CBDS was possible. Even though CBDS tended to be underestimated assessment of exact tumor extension was improved by contrast administration. 相似文献20.