实时组织弹性成像技术应变率比值诊断乳腺癌的价值

The value of diagnosis of breast cancer by strain ratio(SR) of real-time tissue elastography technology

目的探讨实时组织弹性成像技术应变率比值（SR）诊断乳腺癌的价值。方法对51例女性患者62个肿块在病理定性前进行常规超声检查,并按照BI-RADS标准对肿块进行分级;以SR 3.08为界点,判断肿块的良恶性,以病理结果为金标准,比较两种方法诊断乳腺癌的准确性。结果实时组织弹性成像技术应变率比值诊断乳腺恶性肿瘤的敏感度为94.4%（34/36）,特异度为92.3%（24/26）,准确率为93.5%（58/62）,加权Kappa=0.892,曲线下面积（AUC）为0.864（95%CI 0.801-0.943）;常规超声诊断乳腺恶性肿瘤的敏感度为89.1%（33/37）,特异度为88.0%（22/25）,准确率为88.7%（55/62）,加权Kappa=0.881,AUC为0.830（95%CI 0.791-0.912）。结论实时组织弹性成像技术应变率比值作为一种半定量指标,诊断乳腺肿瘤的良恶性简单易行,值得临床推广。

Objective To explore the value of diagnosis of breast cancer by strain ratio（ SR） of real-time tissue elastography technology. Methods Sixty-two breast lesions in 51 female patients were examined with conventional ultrasonic before operation and pathological biopsy,The lesions were graded according to the breast imaging reporting and data system（ BI-RADS）. Real-time tissue elastography technology was performed to diagnose the breast cancer. The accuracy of the conventional ultrasonic and SR were compared. Results The sensitivity,specificity,and accuracy of SR were 94. 4%（ 34 /36）,92. 3%（ 24 /26）,and 93. 5%（ 58 /62）; weighted Kappa was 0. 892; AUC was 0. 864（ 95% CI 0. 801 - 0. 943）. The sensitivity,specificity,and accuracy of conventional ultrasonic were89. 1%（ 33 /37）,88. 0%（ 22 /25）,and 88. 7%（ 55 /62） respectively. weighted kappa was 0. 881 and AUC value was 0. 830（ 95% CI 0. 791 - 0. 912）. The accuracy of SR was higher than that of the convertional ultrasonic（ P〈 0. 05）. Conclusion The accuracy of SR of real-time tissue elastography technology is superior to the conventional ultrasound in the diagnosis of breast malignant lesions.