弹性应变率比值联合乳腺超声影像报告和数据系统诊断乳腺结节的应用价值

目的 探讨弹性应变率比值(SR)与乳腺超声影像报告和数据系统(BI-RADS-US)联合诊断乳腺结节的应用价值。方法 回顾性分析经病理确诊的471例乳腺结节,术前行常规超声及应变弹性成像检查,应用SR联合BI-RADS-US对乳腺结节分类进行分级调整,以病理结果为金标准,通过受试者工作特征(ROC)曲线下面积评估联合法与BI-RADS-US单独诊断乳腺结节的效能,比较两者敏感度、特异度及准确性。结果 471例乳腺结节中,良性180例,恶性291例,联合法诊断乳腺癌的ROC曲线下面积明显高于BI-RADS-US(0.798比0.730;Z=2.583,P=0.010)。SR法、BI-RADS-US及联合法诊断乳腺癌的敏感度分别为86.6%、99.0%、96.6%,特异度分别为67.2%、47.2%、63.3%,准确性分别为79.2%、79.2%、83.9%。联合法较BI-RADS-US单独诊断乳腺癌特异度从47.2%提高到63.3%(χ ²=14.25,P<0.001),将57.5%(42/73)BI-RADS 4A类中的良性结节降为3类。结论 SR联合BI-RADS-US可明显提高乳腺癌的诊断效能,提高诊断特异度,避免不必要的穿刺活检。

Value of Elastography Strain Ratio Combined with Breast Ultrasound Imaging Reporting and Data System in the Diagnosis of Breast Nodules

Objective To explore the value of elastography strain ratio(SR)combined with breast ultrasound imaging reporting and data system(BI-RADS-US)in the differential diagnosis of breast nodules.Methods A total of 471 breast nodules(from 471 patients)were reclassified by SR combined with BI-RADS-US.With the pathology results as gold standard,the area under the receiver operating characteristic(ROC)curve(AUC)was employed to evaluate the diagnostic performance,and the sensitivity,specificity,and accuracy were compared between the combined method and BI-RADS-US.Results Among the 471 breast nodules,180 nodules were benign and 291 were malignant.The AUC of the combined method was statistically significantly higher than that of BI-RADS-US(0.798 vs. 0.730;Z= 2.583, P= 0.010).SR,BI-RADS-US,and the combined method for diagnosing breast nodules had the sensitivity of 86.6%,99.0%,and 96.6%,the specificity of 67.2%,47.2%,and 63.3%,and the accuracy of 79.2%,79.2%,and 83.9%,respectively.The combined method increased the specificity from 47.2%(BI-RADS-US)to 63.3%(χ ²=14.25,P < 0.001),and downgraded 57.5%(42/73)benign nodules of BI-RADS category 4A to category 3.Conclusions SR combined with BI-RADS-US can improve the diagnostic performance for breast nodules.Especially,it can improve the specificity,avoiding unnecessary biopsy of breast nodules.