超声弹性应变率比值在乳腺良恶性肿瘤鉴别诊断中的应用价值

目的探讨弹性应变率比值(SR)对乳腺良恶性肿瘤的诊断价值。方法对301例乳腺肿块患者的301个病灶进行超声弹性成像检查,获得弹性成像图后,测量病灶与周围组织的SR,并与病理诊断结果对照,构建受试者工作特征(ROC)曲线,分析SR诊断良恶性肿瘤的准确性,并确定临界点。结果良性肿瘤的SR(1.21±1.35)显著低于恶性肿瘤的SR(16.51±3.45),差异有统计学意义(P<0.01)。通过ROC曲线确定的最佳诊断临界点是3.905,SR诊断乳腺良恶性肿块的敏感性、特异性、准确性、阳性似然比、阳性预测值和阴性预测值分别是90.9%、84.3%、88.4%、5.805、90.4%、85.1%,曲线下面积(AUC)为0.905。结论 SR测量可以相对更加客观地反映病灶的硬度情况,是一种有效的鉴别乳腺良、恶性肿块的超声弹性成像方法。

Value of Strain Ratio in the Differential Diagnosis of Benign and Malignant Breast Tumors by Ultrasonic Elastography

Objective To investigate the diagnostic value of strain ratio in the differential diagnosis of benign and malignant breast tumors.Methods Ultrasonic elastography was performed in 301 breast tumors of 301 patients to obtain the strain images.The strain ratio of the tumors and surrounding tissues was then calculated and was compared with the results of pathological diagnosis.Receiver operating characteristic(ROC) curve was established to analyze the accuracy of SR in diagnosing benign and malignant tumor and then the cut-off point for the strain ratio was determined.Results The strain ratio of benign tumors was significantly lower than that of malignant ones((1.21±1.35) vs(16.51±3.45),P<0.01).The best cut-off point for strain ratio was 3.905.The sensitivity,specificity,accuracy,positive likelihood ratio,positive predictive value and negative predictive value were 90.9%,84.3%,88.4%,5.805,90.4% and 85.1% respectively.The area under the curve was 0.905.Conclusion Strain ratio could reflect the stiffness of breast tumors and it represents a more objective diagnostic parameter for differentiation of benign and malignant breast tumors.