实时剪切波弹性成像技术在乳腺肿块诊断中的临床应用价值

The clinical value of RT-SWE in the diagnosis of breast mass

目的:探讨实时剪切波弹性成像(RT-SWE)技术在乳腺肿块诊断中的应用价值,为乳腺肿块的鉴别诊断提供新的思路。方法:选取西安交通大学第一附属医院2015年1月-2018年2月收治的500例乳腺肿块患者,以RT-SWE技术行乳腺肿块多切面扫查,以病理检查结果为金标准,对比良性、恶性肿块的弹性模量参数;绘制受试者工作特征曲线(ROC)并分析RESWE技术诊断乳腺肿块的效能,探讨其临床应用价值。结果:共检出667枚乳腺病灶,其中良性肿块408枚、恶性肿块259枚;良性肿块Emax、Emean、Emin、SD、Ratio、剪切波速度均低于恶性肿块,差异有统计学意义(P<0.05)。Emean鉴别乳腺肿块良恶性的曲线下面积最大为0.931,其诊断准确率为91.45%;其次为剪切波速度,其曲线下面积为0.899,诊断准确率为89.81%。结论:RESWE图像Emean、剪切波速度参数能够为乳腺肿块良恶性的鉴别提供客观参考,值得在临床乳腺肿块的诊断中得到广泛应用。

Objective:To explore the application value of real time shear wave elastography(RT-SWE)in the diagnosis of breast masses,and to provide new ideas for the differential diagnosis of breast masses.Methods:500 cases of breast lumps treated in the First Affiliated Hospital of Xi’an Jiaotong University from January 2015 to February 2018 were included in this study.The RT-SWE technique was used to scan the various quadrants of the breast mass,taking the pathological results as the gold standard,the modulus of elasticity of benign and malignant masses was compared.Receiver operating characteristic(ROC)was plotted and the efficacy of RE-SWE in the diagnosis of breast lumps was analyzed,to explore its clinical applica-tion value.Results:667 breast lesions were detected,including 408 benign masses and 259 malignant masses.The Emax,Emean,Emin,SD,ratio and shear wave velocities of benign tumors were all lower than those of malignant masses,the differences are statistically significant(P<0.05).Emeanhas the largest area under the curve(0.931),the diagnostic accuracy is 91.45%in discriminating the benign and malignant breast tumors,followed by the shear wave velocity,the area under the curve is 0.899,and the diagnostic accuracy is 89.81%.Conclusion:The Emeanand shear wave velocity parameters of RT-SWE images can provide an objective reference for differentiating benign and malignant breast masses.It is worthy to be widely applied in the diagno-sis of clinical breast masses.