应变及剪切波弹性成像定量参数联合应用对乳腺结节良恶性的诊断价值

Diagnostic Value of Quantitative Parameters of Strain and Shear Wave Elastography in Benign and Malignant Breast Nodules

【目的】探讨应变弹性成像(SE)及剪切波弹性成像(SWE)定量参数联合应用对乳腺结节良恶性的诊断价值。【方法】回顾性分析2018年1月至2020年10月在本院诊治的132例乳腺疾病患者,所有患者均接受超声弹性成像检查,以病理检查结果为金标准,对比良性与恶性患者的SE参数指标应变率比值(SR)、弹性成像评分,SWE参数指标最大弹性模量值(Emax)、平均值(Emean)、弹性标准差(Esd),病灶与周围组织弹性比(Eratio)、病灶内部与周围弹性比(A/shell);分析SE、SWE及其联合诊断乳腺结节良恶性结果与金标准的一致性,计算诊断效能;以受试者工作特征(ROC)曲线分析SE、SWE及其联合应用对乳腺结节良恶性的诊断价值。【结果】132例患者的136个病灶中良性91个,恶性45个。良性结节SE参数弹性图像评分、SR及SWE参数Emax、Emean、Esd、Eratio、A/shell与恶性结节比较,差异均有统计学意义(P<0.05);SWE参数中Emax对乳腺结节良恶性诊断具有中等价值且高于其他参数(P<0.05),其他各项参数对乳腺结节良恶性均具有较低诊断价值(P<0.05);SE、SWE及其联合诊断与金标准均具有一致性(P<0.05),联合诊断效能最高,敏感度为82.22%、特异度为90.11%、准确率为87.50%;SE、SWE及其联合诊断乳腺结节良恶性具有较中等诊断价值,高于SE、SWE单独应用(P<0.05)。【结论】良性乳腺结节与恶性乳腺结节的SE、SWE参数均具有明确差异性,SE、SWE在乳腺结节良恶性判断方面各具优势,各参数联合应用可提高诊断价值,为评估临床乳腺结节性提供参考。

【Objective】To investigate the diagnostic value of quantitative parameters of strain elastography(SE)and shear wave elastography(SWE)in benign and malignant breast nodules.【Methods】A total of 132 patients with breast diseases diagnosed and treated in our hospital from January 2018 to October 2020 were retrospectively analyzed.All patients underwent ultrasound elastography,and the pathological examination results were the gold standard.The SE parameter index strain rate ratio(SR),elastic imaging score,maximum elastic modulus value(Emax),mean value(Emean),elastic standard deviation(Esd),elastic ratio between lesion and surrounding tissue(Eratio),and elastic ratio between lesion and surrounding tissue(A/shell)of benign and malignant patients were compared;The consistency of SE,SWE and their combined diagnosis of benign and malignant breast nodules with the gold standard was analyzed and the diagnostic efficiency was calculated;The diagnostic value of SE,SWE and their combined application in benign and malignant breast nodules was analyzed by ROC curve.【Results】Among 136 lesions in 132 patients,91 were benign and 45 were malignant.There were significant differences in SE parameters,elastic image score,SR and SWE parameters(Emax,Emean,Esd,Eratio,A/shell)between benign nodules and malignant nodules(P<0.05);Among SWE parameters,Emax has a moderate value in the diagnosis of benign and malignant breast nodules and was higher than other parameters(P<0.05),and other parameters had a lower value in the diagnosis of benign and malignant breast nodules(P<0.05);SE,SWE and their combined diagnosis were consistent with the gold standard(P<0.05).The combined diagnosis had the highest efficacy,with sensitivity of 82.22%,specificity of 90.11%and accuracy of 87.50%;SE,SWE and their combination in the diagnosis of benign and malignant breast nodules had moderate diagnostic value,which was higher than that of SE and SWE alone(P<0.05).【Conclusion】There are clear differences in SE and SWE parameters between benign and malignant breast nodules.SE and SWE have their own advantages in judging the benign and malignant breast nodules.The combined application of these parameters can improve the diagnostic value and provide reference for the evaluation of clinical breast nodules.