超声弹性成像参数在乳腺良、恶性肿块鉴别诊断中的价值

Value of different parameters of ultrasound elastography in the diagnosis of breast lesions

目的:评价超声弹性成像各参数在乳腺良、恶性病灶鉴别诊断中的价值。方法:对300个乳腺病灶的弹性图像进行弹性分级评定、面积比和应变率比值的测定(分别取与病灶同层的正常腺体及病灶旁皮下脂肪为参照组织测得应变率比值SR1和SR2),并对照其术后病理结果(恶性120个,良性180个),对各弹性参数的良、恶性诊断临界值及诊断率进行统计学分析评价。结果:弹性图像分级、面积比和应变率比值在乳腺良、恶性病灶组间均有显著差异(P<0.01),以弹性分级≥3级为恶性诊断标准,其诊断敏感性为94.2%,特异性为81.1%,准确性为86.3%;以面积比1.20为良、恶性病灶鉴别诊断的临界值,其敏感性、特异性和准确性分别为92.5%、80.6%、83.0%;分别以2.44和2.7作为SR1、SR2临界值进行良、恶性鉴别诊断,其诊断准确性分别为77.3%和72.7%。结论:超声弹性成像各参数在乳腺良、恶性肿块的鉴别诊断中均具有一定的诊断意义,其中以弹性分级和面积比参数的诊断价值较高。

Objective： To evaluate the value of different parameters of ultrasound elastography in the differentiating diagnosis of breast lesions. Method： Three hundred breast lesions, 180 malignant and 120 benign ones which were confirmed by pathological results were examined with elastographic ultrasound preoperatively. The elasticity mark, the area ratio and the strain ratio （SR1 and SR2 were calculated using the reference of normal breast tissue of the same-level with the lesion and the subcutaneous fat tissue respectively） of all the breast lesions were recorded. Then their critical value and the sensitivity, specificity, accuracy were analyzed statistically. Result： Statistical differences were found in the aspects of elasticity mark, area ration and strain ration （SR1 and SR2） between the benign and malignant breast lesions （P〈0.01）. When the elasticity mark≥ 3 was defined as malignancy, the sensitivity, specificity and accuracy were 94.2%, 81.1%, 86.3%, respectively. When the area ratio ≥ 1.2 was defined as malignancy, the sensitivity, specificity and accuracy were 92.5%, 80.6%, 83.0%, respectively. When the critical value of SR1=2.44 and SR2=2.7 were used in differentiating diagnosis, the diagnostic accuracy were 77.3% and 72.7% respectively. Conclusion： The parameters of ultrasound elastography, especially the assessment of elasticity mark and arearatio, have diagnostic value in differentiating malignant from benign breast lesions.