超声剪切波弹性模量参数在评估乳腺良恶性病灶中的应用价值比较

Performance of Ultrasonic Shear Wave Elastography in Assessing Benign and Malignant Breast Lesions

目的比较剪切波弹性模量参数弹性最大值(Emax)、平均值(Emean)、最小值(Emin)、标准差(SD)和弹性比值(Eratio)在评价乳腺病灶良恶性中的价值,以确定最具诊断价值的参数。方法 302例经手术或穿刺活检确诊的乳腺病灶纳入研究,采用受试者工作特征曲线(ROC)确定Emax、Emean、Emin、SD、Eratio和超声乳腺影像报告及数据系统(BI-RADS)分类的诊断临界值,比较上述参数独立评价和分别联合超声BI-RADS分类评价乳腺病灶良恶性灵敏度、特异度和约登指数的差异。结果 Emax独立评价和联合超声BI-RADS分类评价乳腺病灶良恶性灵敏度、特异度和约登指数分别为0.87、0.97、0.84和0.86、0.97、0.83,均明显高于其他参数(P均<0.01)。结论 Emax评价乳腺病灶的诊断效能优于其他参数,可作为评价病灶乳腺良恶性的重要参考指标。

Objective To determine the best shear wave elastography（ SWE） quantitative parameters including the maximum elasticity（ Emax）,mean elasticity（ Emean）,minimum elasticity,standard deviation and ratio of Emean（ Eratio） in assessing benign and malignant breast lesions. Methods Totally 302 breast lesions underwent conventional ultrasound and SWE. Each lesion was classified according to ultrasound Breast Imaging Reporting and Data System（ BI-RADS）. The receiver operating characteristic（ ROC） curves were used to determine the cut-off values of SWE quantitative parameters and to suggest breast lesions as benign or malignant. The sensitivity,specificity and the Youden index（ sum of sensitivity and specificity minus 1） of SWEquantitative parameters were compared,and then the sensitivity,specificity and the Youden index of the combinations of each SWE parameters in assessing breast lesions were compared. Results The sensitivity,specificity and the Youden index of the Emax were 0. 87,0. 97 and 0. 84,which were higher than other SWE parameters（ all P〈0. 01）. The sensitivity,specificity and the Youden index of Emax combined with ultrasound BI-RADS were 0. 86,0. 97 and 0. 83,which were higher than other combinations（ all P〈0. 01）. Conclusions Compared with other parameters,Emax has the best performance in assessing breast lesions. It can be used as an important quantitative indicator for the evaluation of benign and malignant breast lesions.