超声CDFI联合RT-SWE鉴别诊断乳腺癌与乳腺良性结节效果

Effect of color Doppler ultrasound combined with real time shear wave elastography for differential diagnosing breast cancer and benign breast nodules

目的:分析高频彩色多普勒超声(CDFI)联合实时剪切波弹性成像(RT-SWE)在乳腺癌与乳腺良性结节中的鉴别诊断价值。方法:选取2019年1月-2021年12月在本院收治的乳腺肿瘤患者118例,根据病理结果分为乳腺癌组(64例)和乳腺良性结节组(54例)。两组均行CDFI及RT-SWE检查,比较两组CDFI检查下乳腺影像报告和数据系统(BI-RADS)分级、超声征象以及RT-SWE检查下弹性模量值,分析CDFI、RT-SWE单独及联合检查鉴别乳腺癌与乳腺良性结节的符合率,根据受试者工作特征(ROC)曲线分析各指标检查对乳腺癌与乳腺良性结节鉴别诊断价值。结果:乳腺良性结节组CDFI检查下BI-RADS分级高于乳腺癌组,存在后方衰减、纵横比≥1、低或极低内部回声、边缘不规则、存在微钙化、实性内部结构占比均低于乳腺癌组,RT-SWE检查下平均弹性模量值(Emean)、最大弹性模量值(Emax)、最小弹性模量值(Emin)值均低于乳腺癌组(均P<0.05);对乳腺癌及乳腺良性结节的阳性与阴性预测率,CDFI分别为80.0%、77.4%,RT-SWE分别为87.3%、83.6%,二者联合分别为93.9%、96.2%;CDFI、RT-SWE及二者联合检查诊断乳腺癌及乳腺良性结节的曲线下面积分别为0.786、0.849、0.913。结论:CDFI和RT-SWE联合检查对乳腺肿瘤良恶性鉴别诊断有较高临床参考价值。

Objective:To analyze the value of high frequency color Doppler ultrasound(CDFI)combined with real time shear wave elastography(RT-SWE)for differential diagnosing breast cancer and benign breast nodules.Methods:118 patients with breast tumor were selected and divided into group A(64 cases with breast cancer)and group B(54 cases with benign breast nodules)according to their pathological results from Jan.2019 to Dec.2021.The patients in both groups rceived CDFI and RT-SWE examinations.The breast imaging reporting,the grading of data system(BI-RADS),and the ultrasound signs by CDFI examination.and the modulus of elasticity by RT SWE examinations of the patients were compared between the two groups.The coincidence rate of the CDFI examination,the RT SWE examina-tion,and the combined examinations of CDFI and RT-SWE for differential diagnosing breast cancer and benign breast nodules was analyzed.The value of the CDFI examination,the RT-SWE examination,and the combined examinations of CDFI and RT-SWE for differential diagnosing breast cancer and benign breast nodules were analyzed by receiver op-erating characteristic(ROC)curve.Results:The breast cancer grading of BI-RADS by CDFI examination of the pa-tients in group B was sigificantly higher than that of the patients in group A,and the rates of the posterior attenua-tion.the aspect ratio≥1,the low or very low internal echo,the edge irregularity,the microcaleification.and the solid internal structure by CDFI examination of the patients in group B were significantly lower than those of the patients in group A.The values of average modulus of elasticity(Emean),maximum modulus of elasticity(Emax),and mini-mum modulus of elasticity(Emin)by RT-SWE examination of the patients in group B were significantly lower than those of the patients in group A(all P<0.05).The positive and negative prediction rates for the breast cancer and the breast benign nodules of the patients by CDFI examination were 80.0%and 77.4%,which by RT SWE examination were 87.3%and 83.6%.The positive and the negative prediction rates of CDFI combined with RT-SWE examinations for the breast cancer and the breast benign nodules of the patients were 93.9%and 96.2%.The areas under the curve of the CDFI examination,the RT SW E examination,and the CDFI combined with RT SWE examinations for diagnosing the breast cancer and the breast benign nodules were 0.786.0.849,and 0.913,respectively.Conclusion:The CDFI combined with RT SWE examinations for differential diagnosing breast cancer and benign breast nodules has high ref-erence value in clinic.