剪切波弹性成像定性技术鉴别诊断乳腺良恶性病变

发布时间：2019-03-22 20:37

【摘要】：目的探讨SWE定性技术在乳腺病灶良恶性鉴别诊断中的应用价值。方法对236例患者共261个病灶行常规超声及SWE检查。以常规超声图像进行乳腺影像报告和数据系统(BI-RADS)分类,将SWE图像分为6种类型。以病理结果为金标准,绘制ROC曲线,评价SWE分型、BI-RADS分类及二者联合的诊断效能。结果良性病灶100个,恶性病灶161个。以SWE分型3型为诊断界点,敏感度、特异度、准确率、阳性预测值、阴性预测值分别为85.71%(138/161)、93.00%(93/100)、88.51%(231/261)、95.17%(138/145)、80.17%(93/116);以BI-RADS 4a类为诊断界点,敏感度、特异度、准确率、阳性预测值、阴性预测值分别为98.76%(159/161)、73.00%(73/100)、88.89%(232/261)、85.48%(159/186)、97.33%(73/75);二者联合诊断的敏感度、特异度、准确率、阳性预测值、阴性预测值分别为99.38%(160/161)、70.00%(70/100)、88.12%(230/261)、84.21%(160/190)、98.59%(70/71)。SWE分型的特异度和阳性预测值均高于BIRADS分类及联合诊断(P均0.05),BI-RADS分类及联合诊断的敏感度和阴性预测值均高于SWE分型(P均0.05),三者诊断准确率差异均无统计学意义(P均0.05)。结论 SWE定性技术有助于乳腺良恶性病灶的鉴别诊断。
[Abstract]:Objective to evaluate the value of SWE in differential diagnosis of benign and malignant breast lesions. Methods 261 lesions of 236 patients were examined by conventional ultrasound and SWE. Breast image reporting and data system (BI-RADS) classification was performed with conventional ultrasound images. SWE images were classified into 6 types. Taking the pathological results as the gold standard, the ROC curve was drawn to evaluate the diagnostic efficacy of SWE classification, BI-RADS classification and the combination of the two. Results there were 100 benign lesions and 161 malignant lesions. The diagnostic threshold, sensitivity, specificity, accuracy, positive predictive value and negative predictive value of SWE type 3 were 85.71% (138 / 161), 93.00% (93 / 100), 88.51% (231 / 261), respectively. 95.17% (138 / 145), 80.17% (93 / 116); The diagnostic threshold, sensitivity, specificity, accuracy, positive predictive value and negative predictive value of BI-RADS 4A were 98.76% (159 / 161), 73.00% (73 / 100), 88.89% (232 / 261), respectively. 85.48% (159 / 186), 97.33% (73 / 75); The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of the combined diagnosis were 99.38% (160 / 161), 70.00% (70 / 100), 88.12% (230 / 261), 84.21% (160 / 190), respectively. The specificity and positive predictive value of SWE classification were higher than those of BIRADS classification and combined diagnosis (all P 0.05), and the sensitivity and negative predictive value of BI-RADS classification and combination diagnosis were higher than those of SWE classification (all P 0.05). There was no significant difference in diagnostic accuracy among the three groups (P 0.05). Conclusion qualitative technique of SWE is helpful for differential diagnosis of benign and malignant lesions of breast.
【作者单位】：中国医科大学附属盛京医院超声科;
【分类号】：R737.9;R445.1

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