剪切波弹性成像对乳腺原位癌的诊断价值分析

Diagnostic Value Analysis of SWE for the Breast Carcinoma in Situ

目的:探讨剪切波弹性成像(SWE)对乳腺原位癌的诊断价值。方法:回顾性分析2015年8月-2017年8月于我院病理证实的26个乳腺原位癌病灶和45个乳腺良性病灶,术前均分别行常规超声检查和SWE检查。比较两组病灶的弹性模量值差异,两种检查方法诊断敏感度、特异度、准确度、阳性预测值、阴性预测值,并构建受试者操作特征(ROC)曲线,分析SWE对乳腺原位癌的诊断价值。结果:乳腺原位癌病灶的弹性模量最大值、平均值、最小值和与脂肪组织弹性比值分别为86.6±26.7 kpa、56.6±21.4kpa、31.3±15.7 kpa、6.7±1.8,均明显高于乳腺良性病灶(P<0.05)。SWE诊断敏感度、特异度、准确度、阳性预测值、阴性预测值分别为92.31%、88.89%、90.14%、82.76%、95.23%,均显著高于常规超声成像(P<0.05)。弹性模量最大值、平均值、最小值及与脂肪组织弹性比值评价乳腺原位癌的ROC曲线下面积分别为0.944、0.876、0.818、0.956。结论:乳腺原位癌病灶的弹性模量值高于良性病灶,SWE对早期发现乳腺原位癌具有重要价值。

Objective:To assess the value of shear wave elasticity(SWE)for the diagnosis of breast carcinoma in situ.Methods:26 cases of breast carcinoma in situ lesions and 45 cases of breast benign lesions which were confirmed by pathology in our hospital and given breast ultrasound examination and shear wave elasticity(SWE)imaging before operation were retrospectively analyzed.The differences of SWE quantitative elastography between breast carcinoma in situ lesions and breast benign lesions were compared.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of two kinds of examination methods were compared,and receiver operating characteristic(ROC)curve were created to evaluate the diagnostic value of shear wave imaging on carcinoma in situ.Results:The maximum,mean,minimum elasticity value and ratio(mass/fat)of breast carcinoma in situ lesions were 86.6±26.7 kpa,56.6±21.4 kpa,31.3±15.7 kpa,6.7±1.8,which were significantly higher than those of the breast benign lesions(P<0.05).The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of breast carcinoma in situ lesions were 92.31%,88.89%,90.14%,82.76%,95.23%,which were significantly higher compared to those of the ultrasound examination(P<0.05).The areas under the ROC curve of the maximum,mean,minimum elasticity value and ratio(mass/fat)were 0.944,0.876,0.818,0.956.Conclusion:SWE quantitative elastography of breast carcinoma in situ lesions is higher than that of the breast benign lesions,SWE has an important value in early detection of carcinoma in situ.