剪切波弹性成像在乳腺良恶性病变鉴别诊断中的价值

目的:应用剪切波超声弹性成像技术测定乳腺良恶性病灶的弹性模量值,评价该技术在乳腺良恶性病变鉴别诊断中的价值。方法:收集我院经手术病理证实的乳腺病变女性患者51例,共67个病灶,行实时剪切波超声弹性成像检查,获得乳腺病变的定量弹性模量值(平均值、最大值、最小值、标准差(SD)),比较弹性模量值与钼靶BI-RADS分级对乳腺良恶性病变的诊断准确性。结果:良性病灶的弹性平均值、最大值及SD分别为(25.21±16.45)kPa、(39.18±31.20)kPa和(6.19±7.66)kPa;恶性病灶的平均值、最大值及SD分别为(59.05±36.19)kPa、(108.72±45.17)kPa和(20.01±12.27)kPa,良恶性病灶的弹性平均值、最大值及SD差异均有统计学意义(P<0.05)。弹性平均值及最大值的曲线下面积(AUC)分别为0.814、0.908,以40.2 kPa、58.79 kPa作为乳腺良恶性病变平均值及最大值的诊断界值,与钼靶BI-RADS分级比较,弹性最大值的诊断准确性优于BI-RADS分级。结论:弹性平均值、最大值及SD可为乳腺良恶性病变的诊断提供诊断依据。弹性最大值比BI-RADS分级在乳腺良恶性病变鉴别诊断中价值高。

The value of shear wave elastography in differential diagnosis of breast lesions

Objective： To obtain the elasticity value of benign and malignant breast lesions with supersonic shear wave elastrography（SWE）,in order to assess the value of quantitative elastography with SWE in differential diagnosis of benign and malignant breast lesions.Methods： SWE was performed in 67 breast lesions of 51 female patients with pathologically confirmed results,to obtain the elastic modulus（mean,maximum,minimum,standard deviation（SD）） of breast lesions.The value of SWE and mammography BI-RADS classification in differential diagnosis of breast lesions was compared.Results： The mean,maximum and SD of elasticity value for benign lesions were（25.21±16.45） kPa,（39.18±31.20） kPa and（6.19±7.66） kPa respectively;whereas those for malignant ones were（59.05±36.19） kPa,（108.72±45.17） kPa and（20.01±12.27） kPa,respectively（P〈0.05）.The area under the curve（AUC） of the mean and maximum elasticity value was 0.814 and 0.908.Taking 40.2 kPa and 58.79 kPa as the threshold of the mean and maximum elasticity value,the diagnostic accuracy of maximum is higher than that of the BI-RADS classification.Conclusion： The mean,maximum and SD of elasticity value can provide diagnostic evidence for benign and malignant breast lesions.Maximum has a higher value than the BI-RADS classification in the differential diagnosis of breast lesions.