超声剪切波弹性定量参数在优化乳腺结节BI-RADS分类中的价值

发布时间：2018-09-04 16:04

【摘要】：目的探讨超声剪切波定量参数在优化乳腺结节BI-RADS分类中的价值。方法穿刺或手术前对126例(132个)乳腺病灶行BI-RADS分类,再行剪切波弹性成像检测,获得乳腺良恶性病灶的剪切波定量参数,以病理结果为金标准,比较BI-RADS分类及其结合弹性最大值Emax评价乳腺良恶性病变的诊断效能,分析Emax对BI-RADS 4a类乳腺病变的诊断价值。结果 132个病灶中,良性病变82个(62.1%),恶性病变50个(37.9%)。恶性病灶组的剪切波定量参数均明显高于良性病灶组,差异具有统计学意义(P0.001)。BI-RADS分类结合Emax评价乳腺良恶性病灶时ROC曲线面积最高;以Emax60.97kPa评价BI-RADS 4a类病变,可使92.3%4a类调整为3类,但通过降类后,可使BI-RADS 3类的假阴性率由0上升为4.23%。结论超声BI-RADS分类结合剪切波Emax有助于提高乳腺良恶性病变诊断的特异度、准确度,对于大多数4a类病变,可以减少不必要的穿刺活检或手术,但对于部分BI-RADS 4a类依据弹性成像降类的可疑小病灶,应综合判断,最大化降低假阴性病例。
[Abstract]:Objective to evaluate the value of ultrasonic shear wave quantitative parameters in optimizing BI-RADS classification of breast nodules. Methods BI-RADS classification was performed in 126 cases (132) of breast lesions before puncture or operation. Shear wave elastic imaging was performed again to obtain the quantitative parameters of shear wave of benign and malignant breast lesions. The pathological results were regarded as gold standard. To compare the diagnostic efficacy of BI-RADS classification and maximum elasticity Emax in the diagnosis of benign and malignant breast lesions, and to analyze the diagnostic value of Emax for BI-RADS 4a breast lesions. Results of 132 lesions, 82 were benign lesions (62.1%) and 50 were malignant lesions (37.9%). The quantitative parameters of shear wave in malignant lesions were significantly higher than those in benign lesions, and the difference was statistically significant (P0.001) .BI-RADS classification combined with Emax to evaluate benign and malignant breast lesions had the highest area of ROC curve, Emax60.97kPa in evaluating BI-RADS 4a lesions could adjust 92.3 J type lesions to 3 categories. However, the false negative rate of BI-RADS 3 can be increased from 0 to 4.23. Conclusion Ultrasound BI-RADS classification combined with shear wave Emax can improve the specificity and accuracy of diagnosis of benign and malignant breast lesions. For most 4a lesions, it can reduce unnecessary puncture biopsy or surgery. However, for some of the suspected small lesions in BI-RADS 4a based on elastic imaging subtraction, we should make a comprehensive judgment to maximize the reduction of false negative cases.
【作者单位】：福建省肿瘤医院超声科;
【基金】：福建省卫计委青年科研课题(No.2015-2-6) 国家临床重点专科建设项目资助[No.(2013)544]
【分类号】：R445.1;R737.9

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