超声弹性成像在乳腺BI-RADS4级病变中的应用价值

目的探讨超声弹性成像对乳腺BI-RADS4级病变良恶性鉴别的应用价值。方法对乳腺65个常规超声BI—RADS4级评分病灶，以术后病理结果为金标准，分析超声弹性图评分、弹性指数及病灶与同深度腺体组织的弹性比值对其良恶性鉴别诊断的应用价值，并构建弹性比值受试者工作特征曲线。结果65个病灶（良性17个，恶性48个）中超声弹性图评分对BI—RADS4级病变良恶性鉴别诊断的敏感性、特异性和准确性分别为81．3％、70．6％和78．5％。良恶性病灶弹性比值差异有统计学意义（P〈0．05）。应用弹性比值鉴别BI．RADS4级乳腺病灶良恶性的曲线下面积为0．753，当弹性比值诊断界值取2．7时，其敏感性66．7％，特异性77．8％。结论超声弹性成像对BI—RADS4级病变良恶性鉴别有较高应用价值。

Value of ultrasonic elastography in differentiating benign and malignant BI-RADS 4 breast lesions

Objective To assess the value of ultrasonic elastography in differentially diagnosing benign and malignant BI-RADS 4 breast lesions. Methods Ultrasonic elastography was performed in 65 BI-RADS 4 breast lesions,which were diagnosed by conventional ultrasound. Pathology of the lesions after operation was considered as the golden standard. Etastogram scoring was analyzed, and elastic index and elastic ratio of lesion at the same depth were calculated. The diagnostic value of elastic ratio for differential diagnosis of benign and malignant lesions was evaluated by receiver operating characteristic curve. Results Pathological examination revealed 17 benign and 48 malignant lesions. The sensitivity, specificity and accuracy of elastogram scoring for benign and malignant BI-RADS 4 lesions were 81.3% ,70.6% and 78.5%, respectively. The elastic ratio of lesions was significantly different between benign and malignant lesions （P 〈 0.05）. Area under the curve of elastic ratio diagnosing benign and malignant breast lesions was 0.753. If the cut-off point of elastic ratio was 2.7, the sensitivity in differentiating breast lesions was 66.7 %, while the specificity was 77.8 %. Conclusion Ultrasonic elastography is a valuable method for differentiating benign and malignant BI-RADS 4 breast lesions diagnosed by conventional ultrasound.