乳腺弹性成像的特征对乳腺结节鉴别诊断的价值

The Value of Elasticity Imaging Features in the Differential Diagnosis of Breast Nodules

目的探讨乳腺弹性成像特征在乳腺结节良恶性鉴别诊断中的应用价值。方法搜集从2014年1月-2016年12月,242个使用乳腺弹性成像定量和半定量参数评估的乳腺结节(参数指标包括:弹性评分、应变率比值、结节最大直径比)。以术后病理结果为金标准。结果传统B型超声诊断良恶性结节敏感性和特异性分别为90%(95%可信区间CI,84~95)和60%(95%CI,48~72);弹性评分敏感性为98%(95%CI,92~99),特异性为46%(95%CI,33~60);应变率比值敏感性为81%(95%CI,71~89),特异性为70%(95%CI,56~81);结节最大直径比敏感性为64%(95%CI,53~75),特异性为76%(95%CI,62~86)。弹性成像指标联合应用要优于任何一种指标的单独应用。结论 B型超声联合弹性成像可显著提高乳腺结节的诊断效能,有较高的临床应用价值。

Objective To assess the role of elasticity imaging features in the differential diagnosis of breast nodules. Methods From January to August 2015, 242 breast lesions were evaluated using elastographic assessment based on qualitative and semi-quantitative parameters （color map, strain ratio, length ratio） as well as elastographic analysis. Histological findings were considered as gold-standard. Results Sensitivity and specificity of B-mode ultrasnund imaging were 90% （95%CI, 84-95） and 60%（95%C1, 48-72）, respectively. Color map sensitivity was 98% （95%CI, 92-99） and specificity 46c~ （95%C1, 33-60） ; strain ratio sensitivity 81% （95%（：1, 71-89） and specificity 70%（95% CI, 56-81）： length ratio sensitivity 64% （95%CI, 53-75）and specificity 76%（95%CI, 62-86）. Combined analysis of these three elastographic features improved the overall diagnostic performance of any of the three parameters alone. Conclusion The B-mode uhrasound combined with elasticity imaging could improve the diagnostic efficacy of breast nodules significantly, and had high clinieal application value.