超声BI-RADS分级结合SWE技术在诊断乳腺良恶性病变中的价值

The value of ultrasound BI-RADS classification combined with SWE in the diagnosis of benign and malignant breast tumors

目的:探讨超声乳腺影像报告和数据系统(Breast Imaging Reporting and Data System,BI-RADS)分级结合实时剪切波弹性成像(shear wave elastography,SWE)技术在诊断乳腺良恶性病变中的价值。方法:选取2017年8月—2018年12月泰州市第四人民医院收治的105例乳腺疾病患者(共105个乳腺病灶),术前病灶行常规超声并进行BI-RADS分级;行SWE检查,测量剪切波速度,以病理学检查结果为金标准,二者结合分析对乳腺良恶性病变的诊断价值。结果:105例患者,共105个病灶,其中良性病灶67个,恶性病灶38个。依据常规超声BI-RADS标准进行分级,3类37例,4A类38例,4B类12例,4C类11例,5类7例,诊断灵敏度、特异度、准确率分别为78.4%、71.2%、76.1%。加入SWE指标后,调整BIRADS分级,结果为3类32例,4A类30例,4B类15例,4C类18例,5类10例,诊断灵敏度、特异度、准确率分别为85.2%、91.3%、84.2%,差异有统计学意义(P<0.05)。结论:超声BI-RADS分级结合SWE能够提高乳腺良恶性病变诊断的准确率。

Objective:The value of ultrasound Breast Imaging Reporting and Data System(BI-RADS)grading combined with real-time shear wave elastography(SWE)in the diagnosis of benign and malignant breast lesions.Methods:A total of 105 patients with breast diseases(105 breast lesions)admitted to The Fourth People’s Hospital of Taizhou from Aug.2017 to Dec.2018 were selected.Preoperative lesions were graded by conventional ultrasound BI-RADS.SWE examination was performed and shear wave velocity was measured.Pathological results were taken as the gold standard to evaluate the diagnostic significance of the combination of the two for benign and malignant breast lesions.Results:There were 105 patients with 105 lesions,of which 67 were benign lesions and 38 were malignant lesions.According to conventional ultrasound BI-RADS standards,37 cases were classified as 3 types,38 cases were classified as 4 A,12 cases were classified as 4 B,11 cases were classified as 4 C,and 7 cases were classified as 5;the diagnostic sensitivity,specificity,and accuracy were 78.4%,71.2%,and 76.1%,respectively.After adding the SWE index,the BI-RADS classification was adjusted,and the results were 32 cases of type 3,30 cases of type 4 A,15 cases of type 4 B,18 cases of type 4 C,and 10 cases of type 5;the diagnostic sensitivity,specificity,and accuracy were 85.2%,91.3%,84.2%,respectively.The difference was statistically significant(P<0.05).Conclusion:BI-RADS classification combined with SWE can improve the accuracy of the diagnosis of benign and malignant breast lesions.