剪切波弹性定量技术及“硬边”征鉴别诊断乳腺实性肿块

发布时间：2018-12-21 12:38

【摘要】：目的探讨剪切波弹性(SWE)定量技术鉴别诊断乳腺良恶性实性肿块的价值。方法选择因乳腺实性肿块接受手术治疗的患者119例(142个病灶)进行剪切波弹性成像。观察特征性弹性"硬边"征,并测量病灶的弹性最大值、最小值、平均值及其与临近脂肪组织的标准差(SD)、与临近脂肪组织的弹性比(SWE-ratio)。结果乳腺癌38例,共40个肿瘤;乳腺良性肿瘤81例,102个肿瘤。弹性最大值、最小值、平均值、SD和SWE-Ratio预测乳腺癌的ROC曲线下面积分别为0.98、0.83、0.97、0.98、0.87。弹性"硬边"征、超声乳腺影像报告和数据系统(BI-RADS)预测乳腺恶性肿瘤的敏感度、特异度分别为90.0%、99.0%;90.0%、90.2%。超声BI-RADS联合弹性"硬边"征预测乳腺恶性肿瘤的敏感度、特异度为97.5%、94.6%。结论剪切波弹性最大值、平均值和SD值对乳腺良恶性肿瘤的鉴别诊断具有重要的临床价值。以0~180kPa为量程,剪切波弹性"硬边"征可作为评价乳腺恶性病灶的独立预测指标。BI-RADS联合弹性"硬边"征可提高乳腺恶性肿瘤的诊断效能。
[Abstract]:Objective to evaluate the value of shear wave elastic (SWE) technique in differential diagnosis of breast benign and malignant solid masses. Methods Shear wave elastography was performed in 119 patients (142 lesions) who underwent surgical treatment for solid breast masses. The characteristic elastic "hard edge" sign was observed, and the maximum and minimum elastic values, the mean value and the ratio of elasticity (SWE-ratio) to the standard deviation of adjacent adipose tissue (SD),) and adjacent adipose tissue (SWE-ratio) were measured. Results 38 cases of breast cancer (40 tumors), 81 cases of benign breast tumors, 102 tumors. The maximum, minimum, average value, SD and SWE-Ratio predicted the area under the ROC curve of breast cancer were 0.98 / 0.830.97 / 0.87, respectively. The sensitivity of elastic "hard edge" sign, ultrasonic mammography report and data system (BI-RADS) in predicting breast malignant tumor was 90.00.0.The specificity was 90.00.90% and 90.2% respectively. The sensitivity of ultrasonic BI-RADS combined with elastic "hard edge" sign in predicting breast malignant tumor was 97.50.94. 6%. Conclusion the maximum value, mean value and SD value of shear wave elasticity have important clinical value in differential diagnosis of breast benign and malignant tumors. With 0~180kPa as the range, shear wave elastic "hard edge" sign can be used as an independent predictor of breast malignant lesions. BI-RADS combined with elastic "hard edge" sign can improve the diagnostic efficacy of breast malignant tumors.
【作者单位】：广东省中医院超声科;广东省中医院乳腺科;广东省中医院病理科;
【基金】：广东省医学科研基金项目(B2013172)
【分类号】：R737.9;R445.1

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