剪切波弹性成像和超微血管成像辨别乳腺早期恶性病变的价值

Differentiation value of shear wave elastography and superb microvascular imaging for breast early malignant lesions

目的:探讨超声剪切波弹性成像(SWE)和超微血管成像(SVI)辨别乳腺早期恶性病变的价值。方法:收集2020年1月至2021年7月收治的病理确诊为乳腺恶性病变的病例62例,其中38例为早期(TNMⅠ~Ⅱ期),24例为中晚期(TNMⅢ~Ⅳ期)。根据年龄、BMI匹配选取乳腺良性病变62例为对照。两组均行SWE和MVI检查,记录最大弹性模量(Emax)、最小弹性模量(Emin)、平均弹性模量(Emean)、病灶与周围组织弹性模量比值(Eratio)以及血流信号分级等参数值。结果:恶性病变组Emax、Emin、Emean和Eratio均高于良性病变组;乳腺恶性病变中晚期组Emax、Emean、Eratio和血流信号分级均高于早期组(P<0.05)。Emax、Emean、Eratio和血流信号分级诊断乳腺病变良恶性的ROC曲线下面积(AUC)及其95%CI分别为0.864(0.824~0.897)、0.732(0.658~0.802)、0.842(0.804~0.885)和0.859(0.812~0.892),Emax+血流信号分级和Eratio+血流信号分级诊断的AUC(95%CI)为0.903(0.823~0.956)和0.889(0.832~0.941)。Emax、Emean、Eratio和血流信号分级辨别乳腺恶性病变早、中晚期的AUC(95%CI)分别为0.821(0.768~0.857)、0.685(0.605~0.762)、0.842(0.804~0.885)和0.775(0.710~0.834),Emax+血流信号分级和Eratio+血流信号分级诊断的AUC(95%CI)为0.876(0.832~0.901)和0.844(0.811~0.876)。结论:SWE和SVI对于乳腺早期恶性病变的诊断有较高的应有价值。

Aim:To explore the value of ultrasound shear wave elastography(SWE) and superb microvascular imaging(SVI) for breast early malignant lesions.Methods:The clinical data of 62 patients with breast cancer(malignant breast lesion group) from January 2020 to July 2021 were retrospectively summarized,and all the cases were confirmed by patholigy;38 patients were in the early stage(TNM stage Ⅰ+Ⅱ) and 24 patients were in the middle and advanced stage(TNM stage Ⅲ+Ⅳ).Another 62 patients with benign lesions matched by age and BMI were selected as control.All lesions were examined by SWE and MVI to obtain the maximum elastic modulus(Emax),the minimum elastic modulus(Emin),the average elastic modulus(Emean),the ratio of the elastic modulus of the lesion to the surrounding tissue(Eratio),and the blood flow signal classification(BFSC).Results:Emax,Emin,Emean,Eratio and BFSC of the malignant breast lesion group were significantly higher than those of the benign lesion group(P<0.05).Emax,Emean,Eratio and BFSC in middle and advanced breast cancer group were significantly higher than those of the early stage breast cancer group(P<0.05).The ROC curve AUC(95%CI) of Emax,Emean,Eratio,BFSC,Emax+BFSC and Eratio+BFSC to diagnose benign and malignant breast lesions were 0.864(0.824-0.897),0.732(0.658-0.802),0.842(0.804-0.885),0.859(0.812-0.892),0.903(0.823-0.956) and 0.889(0.832-0.941),respectively.The AUC(95%CI) of the indexes mentioned above to distinguish the stage of breast cancer were 0.821(0.768-0.857),0.685(0.605-0.762),0.842(0.804-0.885),0.775(0.710-0.834),0.876(0.832-0.901) and 0.844(0.811-0.876).Conclusion:SWE and SVI have high diagnostic value for breast early malignant lesions.