超声弹性成像应变率比值法在乳腺良恶性肿块中的诊断价值

Value of strain ratio by ultrasonic elastography in diagnosis of benign and malignant breast masses

目的探讨超声弹性成像应变率比值对乳腺肿块良恶性的诊断准确性。方法对162例患者的173个乳腺肿块分别进行常规超声和超声弹性成像超声检查,测量肿块周围正常乳腺组织与肿块组织间的超声弹性成像应变率比值(E2/E1),并将结果与术后病理结果进行比较。结果超声弹性成像应变率比值法诊断乳腺肿块的ROC曲线下面积为0.950(95%CI,0.916～0.983),取约登指数最大值(0.779)时的截断点,确定E2/E1=0.355为诊断良恶性肿块的最佳临界点。良性肿块的E2/E1为0.57±0.15,恶性肿块的E2/E1为0.29±0.08,二者比较差异有统计学意义(P<0.05)。超声弹性成像应变率比值法与常规超声对乳腺恶性肿块的敏感性差异无统计学意义,但联合应用二者较单独应用超声弹性成像应变率比值法敏感性有显著提高(P<0.05)。结论超声弹性成像应变率比值作为一项相对客观诊断乳腺良恶性病变的半定量指标,具有较高的诊断准确性,与常规超声联合应用可提高乳腺恶性肿块的检出率。

Objective To evaluate the accuracy of the strain ratio by ultrasonic elastography in diagnosis of benign and malignant breast masses.Methods One hundred and seventy-three breast lesions in 162 cases were examined with high frequency sonography and elastography.The strain ratio(E2/E1) between normal breast tissue and mass was measured and compared with pathological diagnosis.Results The area under the ROC curve(AUC)of strain ratio method in diagnosis of benign and malignant breast tumors are 0.950(95% CI,0.916～0.983).The cut-off point of maximum Yuden index was established(0.779)and then the critical point of strain ratio for the diagnosis of benign and malignant breast masses was 0.355.The value of E2/E1 of benign and malignant masses were 0.57±0.15 and 0.29±0.08,repectively,which were significantly differently(P<0.05).There was no significant difference between strain ratio method and conventional ultrasonography for diagnosis of breast masses.But the combined application of the two methods could significantly improve positive detection rate than single method(P<0.05).Conclusion The strain ratio method has a highly accuracy in diagnosis of benign and malignant breast masses and can improve the detection rate of malignant breast tumor when combined with conventional ultrasonogrphy.