摘要
目的探讨剪切波弹性成像（shear wave elastography，SWE）定量测定乳腺实性病变的弹性模量值对乳腺实性病变良恶性诊断的价值。方法对103例女性患者共125个乳腺实性病变行SWE检查，进行乳腺病灶弹性模量定量测定，以手术病理结果为诊断金标准构建ROC曲线，评价SWE定量测值在乳腺实性病灶良恶性诊断方面的价值。结果病理诊断良性66例（87个病灶），恶性37例（38个病灶），恶性病灶的最大弹性模量值中位数、最小弹性模量值中位数、平均弹性模量值中位数分别为192．0（42．7—300．0）kPa、68．1（0．1—192．0）kPa、138．0（23．9—271．1）kPa良性病灶的最大弹性模量值中位数、最小弹性模量值中位数、平均弹性模量值中位数分别为47．2（7．4—192．0）kPa、22．4（1．8—90．7）kPa、36．3（5．3—124．7）kPa；良恶性病变间的最大弹性模量值、最小弹性模量值、平均弹性模量值间差异均有统计学意义（Pd0．01）。乳腺病灶最大弹性模量值、最小弹性模量值与平均弹性模量值对诊断乳腺良恶性病灶的R0c曲线下面积分别为0．935、0．853和0．917（Pd0．01）。分别以乳腺病灶最大弹性模量值87．65kPa、最小弹性模量值37．15kPa和平均弹性模量值66．85kPa为诊断界值时，诊断良恶性病变的敏感度、特异度分别为91．4％、88．5％，80．0％、83．9％和85．7％、88．5％。结论SwE可以定量测定乳腺肿物的硬度，病灶的弹性模量值可为判断乳腺实性病灶良恶性提供诊断依据。
Objective To obtain the elasticity value of benign and malignant breast solid lesion with real-time shear wave elastography （SWE）, in order to assess the value of quantitative elastography with SWE in diagnosis of benign and malignant breast solid lesions. Methods From June 2012 to November 2012,SWE was performed in 125 breast lesions of 103 female patients with pathologically confirmed results, to obtain the elastic modulus （mean, maximum, minimum）. Taking pathologic results as reference, ROC curves were used to assess diagnostic performance. Results 87 lesions of 66 patients were pathologically confirmed benign whereas 38 lesions of 37 patients were malignant. The maximum,mean,and minimum elasticity value of benign lesions was 47.2 （7.4 - 192.0） kPa, 22.4 （ 1.8 - 90.7） kPa, 36.3 （5.3 - 124. 7）kPa; whereas of malignant ones was 192.0（42.7 - 300.0）kPa,68.1 （0.1 - 192.0）kPa, 138.0（23.9 - 271.1）kPa. The maximum, minimum and mean elasticity value between benign and malignant lesions had statistically significant difference（ P d0.01）. The area under the ROC curve of the maximum, minimum and mean elasticity value was 0. 935,0. 853 and 0. 917（ P d0.01）. Taking 87.65 kPa as the threshold of the maximum elasticity value,the sensitivity was 91.4~ and the specificity was 88.5~. Taking 37.15 kPa as the threshold of the minimum elasticity value, the sensitivity was 80.0~ and the specificity was 83.9~. Taking 66.85 kPa as the threshold of the mean elasticity value,the sensitivity was 85.7~~ and the specificity was 88.5~. Conclusions SWE can assess the stiffness of the breast solid neoplasm by quantitatively measuring the elastic modulus, thus providing diagnostic basis in differential diagnosis of breast lesions. SWE elastic modulus value measurement for breast solid lesions provides a new effective and objective diagnostic method.
出处
《中华超声影像学杂志》
CSCD
北大核心
2014年第2期129-132,共4页
Chinese Journal of Ultrasonography
关键词
超声检查
乳腺肿瘤
剪切波弹性成像
Ultrasonography
Breast neoplasms
Shear wave elastography
