实时剪切波弹性成像技术在鉴别乳腺良恶性病灶应用中的价值

目的应用实时剪切波弹性成像技术的定量性,测定乳腺实质性病灶的杨氏模量值,以病理诊断为标准,评价该技术在乳腺病灶良恶性鉴别诊断中的应用价值。方法对112例患者的乳腺病灶进行剪切波弹性成像检查,并测量其杨氏模量值(最大值Emax及平均值Emean)。以病理诊断结果作为"金标准",绘制ROC曲线图,得出不同性质病灶的杨氏模量临界参考值。结果病理诊断良性85例,恶性27例。良性病灶的Emax及Emean分别为(37.85±13.74)和(23.64±11.38)kPa,恶性病灶的Emax及Emean分别为(98.87±41.65)和(60.84±24.28)kPa,两者差异均有统计学意义(<0.05);Emax的曲线下面积为0.932,大于Emean的0.915,分别以44.68、63.40 kPa作为乳腺良恶性病变Emean及Emax的杨氏模量临界值时,诊断的敏感性、特异性为83.2%、94.5%和78.1%、97.3%。结论根据乳腺病灶的杨氏模量最大值及平均值可以定量的评价肿物的硬度,为鉴别乳腺病灶的良恶性提供了一种新的可靠的诊断依据。

The value of shear wave elastography in differential diagnosis of benign and malignant breast lesions

Objective： To obtain the elasticity value of solid breast lesions with supersonic shear wave elastrography （SWE） and to observe the value of quantitative elastography with SWE in differential diagnosis of breast tumors with pathological diagnosis as the standard. Methods： SWE quantitative elastography was preformed in 112 patients to obtain the elastic modulus （mean, maximum）, taking pathologic results as reference. And ROC curves were used to assess critical reference values of benign and malignant breast lesions. Results： Eighty-five lesions were benign and 22 lesions were malignant according to the pathological tests. The mean elasticity value of benign lesions was （23.64±11.38） kPa, and the maximum value was （37.85±13.74） kPa, while those of malignant lesions were （60.84±24.28） and（98.87±41.65） kPa, respectively （P 〈 0.05）. The area under the ROC curve of the maximum and mean elasticity value was 0.932 and 0.915. Taking 63.40 kPa as the threshold of the maximum elasticity value, the sensitivity was 78.1% and the specificity was 97.3%. Taking 44.68 kPa as the threshold of the mean elasticity value, the sensitivity was 83.2% and the specificity was 94.5%, Conclusions： SWE provides quantitative elasticity measu- rements, thus adding complementary information that can potentially help in differential of breast lesions.