剪切波弹性成像定量技术诊断乳腺良恶性肿瘤的临床研究

Quantitative technique of shear wave elastography in diagnosing benign and malignant breast tumors

目的用剪切波弹性成像技术(SWE)定量测定乳腺良恶性肿瘤弹性模量值,评价对乳腺癌的诊断价值和临床意义。方法以中国医科大学附属第四医院415例女性乳腺肿瘤患者为研究对象,测定乳腺病变组织最大弹性模量值(Emax)和平均弹性模量值(Emean),分析与乳腺癌不同临床分期、分级及肿瘤大小的相关性,绘制ROC曲线,并计算其曲线下面积(AUC)。结果乳腺癌晚期(Ⅲ期+Ⅳ期)Emax和Emean高于早期(Ⅰ期、Ⅱ期),且Ⅱ期Emax和Emean高于Ⅰ期,组织学分级Ⅲ级(低分化)Emax和Emean高于Ⅱ级(中分化)、Ⅰ级(高分化),且Ⅱ级(中分化)高于Ⅰ级(高分化);肿瘤大小与Emax和Emean呈正相关。ROC曲线显示,良恶性肿瘤诊断Emax及Emean临界值分别为:60.5 k Pa、31.5 k Pa,其诊断灵敏度、特异度、准确性分别为:90.8%、96.2%、93.5%和89.9%、91.9%、90.8%。结论剪切波弹性成像定量技术对诊断乳腺良恶性肿瘤具有重要的价值和临床意义。

Objective： Shearwaveelastography（SWE） was used to quantitatively measure the elastic modulus of benign and malignant breast tumors and evaluate its diagnostic valueand clinical significance in breast cancer.Method：The maximum modulus of elasticity （Emax） and the average modulus of elasticity （Emean） were measured in 415 cases of female tumor in our hospital.,and to analyze their correlation with different clinical stages, grades, and tumor sizes of breast cancer.The receiver operating characteristic （ROC） curve is drawn and the area under curve （AUC） is calculated.Results：Emax and Emean were significantly higher in the breast cancer group than in the benign tumor group （P〈0.05）; Emax and Emean were significantly higher in the late （Ⅲ＋IV） period than in the early （stages I and II）,The stage Ⅱ was higher than stage I;and the well-differentiatedgroup（gradeI） was significantlylower than the moderately-differentiated group （grades Ⅱ and Ⅲ）. The difference was statistically significant （P〈 0.05）;Tumor size was significantly correlated with Emax and Emean, and positively correlated;The ROC curve showed that the critical values of Emax and Emean in the diagnosis of benign and malignant tumors were 60.5kPa and 31.5kPa respectively. The sensitivity, specificity and accuracy of the diagnosis were 90.8%, 96.2%, 93.5% and 89.9%, 91.9% and 90.8% respectively.？Conclusion：Shear wave elastography quantitative technique is of great value and clinical significance in the diagnosis of benign and malignant breast tumors.