特发性肉芽肿性乳腺炎和乳腺癌在超声弹性成像应变比上的差异

The Difference of Strain Ratio in Ultrasonic Elastography Between Idiopathic Granulomatous Mastitis and Breast Cancer

目的研究特发性肉芽肿性乳腺炎(IGM)的超声弹性成像特征,并比较IGM和乳腺癌的弹性应变比。方法通过回顾2016年1月至2017年8月,在我院超声引导下粗针活检的21例IGM患者和55例乳腺癌患者纳入研究,并在活检前均行常规超声及超声弹性成像检查,用周围正常乳腺组织作为参照计算病灶的弹性应变比,并比较两组差异。绘制ROC曲线,计算灵敏度、特异度、截断值和曲线下面积(AUC)。结果 IGM的超声弹性成像应变比SR值为1. 6±0. 9,乳腺癌的SR值为5. 5±5. 2,两者差异具有统计学意义(P<0. 05)。绘制ROC曲线,得到AUC为0. 939 (95%CI:0. 882～0. 995,P<0. 000 1)。弹性应变比的最佳截断值为2. 5,诊断IGM的相应灵敏度和特异度分别为87%和96%。结论超声弹性成像应变比可用于鉴别IGM和乳腺癌,并影响进一步活检的临床决策。

Objective To study the ultrasonic elastography features of idiopathic granulomatous mastitis(IGM)and to compare the elastic strain ratio of IGM and breast cancer.Methods 21 cases of IGM and 55 cases of breast cancer admitted in our hospital from January 2016 to August 2017 were selected in the study and diagnosed by ultrasound guided core needle biopsy.All cases were given conventional ultrasound and ultrasonic elastography before biopsy.The elastic strain ratios of lesions in both groups were calculated,using surrounding normal breast tissues as the reference.Differences were compared between the two groups.Receiver-operating-characteristics(ROC)curves were drawn and the sensitivity,specificity,cut-off values and area under curve(AUC)values were calculated.Results The SR value of IGM was 1.6±0.9 while it was 5.5±5.2 for breast cancer,and the difference was statistically significant(P<0.05).After ROC curves were drawn,AUC was 0.939(95%CI:0.882~0.995,P<0.000 1).The optimal cut-off value of the elastic strain ratio was 2.5 and the corresponding sensitivity and specificity of diagnosing IGM were 87%and 96%respectively.Conclusion Ultrasound elastography strain ratio can be used to differentiate IGM from breast cancer and influence clinical decisions for further biopsy.