实时组织弹性成像在乳腺BI-RADS 4级病灶中的诊断价值

对常规超声诊断为乳腺影像学报告和数据系统(BI-RADS) 4级并经实时组织弹性成像(RTE)评估的135例患者共147个乳腺病灶进行回顾性分析,对照病理结果,构建应变比值(SR)鉴别乳腺肿瘤良恶性的受试者工作特性曲线(ROC),并评价改良5分法对乳腺良恶性病灶的诊断效能.改良5分法鉴别BI-RADS 4级乳腺病灶良恶性的敏感度82.26%、特异度83.53%、阳性预测值78.46%、阴性预测值86.59%,良性与恶性乳腺病灶的SR值差异有统计学意义(t=8.65,P<0.001),SR值测量法鉴别乳腺良恶性病灶的曲线下面积为0.866,当诊断界值为2.365时,诊断价值最高,敏感度为93.5%,特异度为65.9%,表明超声弹性成像技术在鉴别BI-RADS 4级乳腺病灶时有较高的诊断效能.

Diagnostic value of real-time tissue elastography for BI-RADS category 4 breast lesions

One hundred and thirty-five cases of patients with a total of 147 breast lesions were examined by conventional ultrasound and diagnosed as breast imaging report and data system(BI-RADS) category 4 level, then elastography was performed using real-time tissue elasticity imaging (RTE).Taking pathological results as golden standard, we evaluated the efficiency of improved 5-point method and constructed receiver operating characteristic curve(ROC) of strain ratio(SR) measurement method in the differential diagnosis of benign and malignant breast lesions.The sensitivity, specificity, positive predictive value(PPV) and negative predictive value (NPV)of improved 5-point method for diagnosis of BI-RADS category 4 breast lesions were 82.26%,83.53%,78.46% and 86.59%, respectively.The SR values of benign and malignant breast lesions had significant difference (t=8.65, P<0.001).The area under the curve (AUC) of SR measurement method in differential diagnosis of breast benign and malignant lesions was 0.866.When the diagnostic cut-off point was 2.365, the sensitivity and specificity was 93.5% and 65.9%, respectively, suggesting that ultrasound elastography has a high diagnostic power in the identification of BI-RADS grade 4 breast lesions.