三维剪切波弹性成像对乳腺肿块定性诊断的价值分析

Value of Three-dimensional Shear Wave Elastography in the Qualitative Diagnosis of Breast Mass

目的:探讨三维剪切波弹性成像(3D-SWE)对乳腺病变定性诊断的价值。方法:收集95例乳腺肿块患者的临床资料,共104个病灶,比较良、恶性病灶行3D-SWE检查中最大弹性测量值(Emax)、平均弹性值(E_(mean))、弹性图像的标准差(E_(sd))与脂肪组织的弹性比值(E_(ratio));ROC曲线分析3D-SWE不同参数对乳腺良恶性病变的诊断价值。结果:3D-SWE检查中良性病灶E_(max)[(85.73±22.44)vs(127.49±37.08)kPa]、E_(mean)[(30.62±5.90)vs(38.23±7.39)kPa]、E_(sd)[(7.05±2.41)vs(11.14±3.76)kPa]、E_(ratio)(5.06±1.29 vs 8.64±2.67)均显著低于乳腺恶性病灶(P<0.05)。ROC曲线分析显示,联合诊断的AUC要高于各项指标单独检测。超声检查恶性病灶误诊为良性6个,良性病灶误诊为恶性10个;3D-SWE检查恶性病灶误诊为良性4个,良性病灶误诊为恶性6个;二者联合诊断准确率显著优于超声检查(97.12%vs 84.62%,P<0.05)。结论:在3D-SWE检查中乳腺恶性病变的E_(max)、E_(mean)、E_(sd)和E_(ratio)均显著高于良性病变,3D-SWE和超声检查联合对乳腺良恶性病变的诊断价值均优于超声检测。

Objective:To explore the value of three-dimensional shear wave elastography(3D-SWE)in the qualitative diagnosis of breast lesions.Methods:The clinical data of 95 patients with breast lumps(104 lesions)were collected.The measurement values of maximum elasticity(E_(max)),mean elasticity value(E_(mean)),standard deviation of elasticity image(E_(sd))and elasticity ratio(E_(ratio))in benign and malignant lesions by 3D-SWE examination were compared.The diagnostic value of different 3D-SWE parameters for benign and malignant breast lesions was analyzed by ROC curves.Results:In 3D-SWE examination,levels of E_(max)[(85.73±22.44)vs(127.49±37.08)kPa],E_(mean)[(30.62±5.90)vs(38.23±7.39)kPa],E_(sd)[(7.05±2.41)vs(11.14±3.76)kPa]and E_(ratio)(5.06±1.29 vs 8.64±2.67)in patients with benign breast lumps were significantly lower than those with malignant lumps(P<0.05).ROC curve analysis showed that AUC of combined detection was greater than that of single index.In ultrasound examination,there were 6 cases with malignant lesions misdiagnosed as benign lesions,and 10 cases with benign lesions misdiagnosed as malignant lesions.In 3D-SWE examination,there were 4 cases with malignant lesions misdiagnosed as benign lesions,and 6 cases with benign lesions misdiagnosed as malignant lesions.The diagnostic accuracy rate of ultrasound combined with 3D-SWE was significantly better than that of ultrasound(97.12%vs 84.62%,P<0.05).Conclusion:In 3D-SWE examination,levels of E_(max),E_(mean),E_(sd) and E_(ratio) in patients with malignant breast lesions are significantly higher than those with benign lesions.The diagnostic value of 3D-SWE combined with ultrasound is better than that of ultrasound for benign and malignant breast lesions.