三维剪切波弹性成像联合超微血流成像对乳腺结节良恶性的诊断价值

Diagnostic value of 3D-SWE combined with SMI in benign and malignant breast nodules

目的:探讨三维剪切波弹性成像(3D-SWE)联合超微血流成像(SMI)对乳腺结节良恶性的诊断价值。方法:选取102例乳腺结节女性患者(102个结节)为研究对象。所有患者术前均行常规超声(US)、3D-SWE及SMI检查。以病理结果为金标准,分析单一检查及联合检查的诊断效能。结果:3D-SWE冠状面(C)、纵切面(T)与横断面(A)敏感性比较,差异有统计学意义(P<0.05)。US、3D-SWE(C)、SMI以及SMI+3D-SWE(C)+US敏感性、特异性、准确率、阳性预测值、阴性预测值比较均存在统计学差异(均P<0.05)。AUC值比较:US与SMI、SWE(C)比较差异均有统计学意义(Z=2.280、2.681,均P<0.05);SMI与SWE(C)比较差异无统计学意义(Z=0.6814,P>0.05);US+SMI+3D-SWE(C)与US、SMI、3D-SWE(C)比较差异均有统计学意义(Z=5.097、3.244、2.706,均P<0.05)。结论:3D-SWE定性诊断乳腺良恶性结节有较高的诊断效能;SMI对乳腺结节良恶性诊断有一定的价值;US+SMI+3D-SWE(C)联合诊断较单一方式更有价值。

Objective:To explore the diagnostic value of three-dimensional shear wave elastography(3D-SWE)combined with super microvascular imaging(SMI)in benign and malignant breast nodules.Methods:A total of 102 nodules in 102 female patients with breast nodules were selected.All patients underwent routine ultrasound(US),3D-SWE and SMI examinations before surgery.Taking pathological results as the gold standard,the diagnostic efficacy of single examination and combined examination were analyzed.Results:There was statistically significant difference in 3D-SWE sensitivity between coronal section(C),longitudinal section(T)and cross section(A)(P<0.05).The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of US,3D-SWE(C),SMI and SMI+3D-SWE(C)+US were statistically different(all P<0.05).Comparison of AUC values:US,SMI,and SWE(C)had statistically significant differences(Z=2.280,2.681,all P<0.05);SMI and SWE(C)had no statistically significant differences(Z=0.6814,P>0.05);the differences between US+SMI+3D-SWE(C)and US,SMI,and 3D-SWE(C)were statistically significant(Z=5.097,3.244,2.706,all P<0.05).Conclusion:3D-SWE qualitatively diagnoses benign and malignant breast nodules with high diagnostic efficiency;SMI has certain value in the diagnosis of benign and malignant breast nodules;combined US+SMI+3D-SWE(C)diagnosis is more valuable than single method.