剪切波弹性成像与脉冲多普勒参数在乳腺病变中的诊断性能比较

Comparison of Diagnostic Performance of Shear Wave Elastographyand Pulsed Wave Doppler Parameters in Breast Lesions

目的 分析剪切波弹性成像(SWE)和脉冲多普勒(PW)对乳腺良恶性病变的诊断性能,并探讨弹性模量值与血流参数的潜在联系。方法 选取2019年8月-2021年2月于安徽医科大学第一附属医院就诊的349例患者(共356个病变)作为研究对象,均行PW和SWE检查,获得SWE参数包括E-max、E-mean、E-min、E-sd、E-ratio,PW参数包括PI、RI、PSV、EDV。以病理结果为金标准,分析血流参数及弹性模量值对乳腺病变的诊断效能,并探讨SWE与PW参数的相关性。结果 根据病理结果将病变分为良性组及恶性组,结果显示两组E-max、E-mean、E-min、E-sd、E-ratio、PI、RI、PSV、EDV比较,差异有统计学意义(P<0.05);其中,E-max和E-sd的AUC最佳,分别为0.912和0.903,以E-max>84.45 Kpa为截断值时,E-max诊断乳腺病变良恶性的灵敏度为91.51%;以E-sd>22.35 Kpa为截断值时,E-sd诊断乳腺病变良恶性的特异度为86.38%;以RI>0.70为截断值时,RI诊断乳腺病变良恶性的特异度为89.00%,以PI>1.07为截断值时,PI诊断乳腺病变良恶性的灵敏度为85.45%。相关性分析显示,E-max与PI(r=0.793,P<0.05)和RI(r=0.767,P<0.05)呈中等相关,E-sd与PI(r=0.752,P<0.05)和RI(r=0.731,P<0.05)呈中等相关。在恶性组中,E-max、E-sd与PI、RI存在相关性,良性组中各参数均无相关性。结论 SWE与PW参数对乳腺病变的诊断性能相似,且SWE与PW参数在乳腺病变中有相关性,尤其是恶性病变中存在显著相关,可反映乳腺病变的弹性特征和血管特征之间存在的内在联系。

Objective To analyze the diagnostic performance of shear wave elastography(SWE)and pulsed wave Doppler(PW)in benign and malignant breast lesions,and to explore the potential relationship between elastic modulus and blood flow parameters.Methods A total of 349 patients(356 lesions in total)who were admitted to the First Affiliated Hospital of Anhui Medical University from August 2019 to February 2021 were selected as the research objects.All patients underwent PW and SWE examinations.The obtained SWE parameters included E-max,E-mean,E-min,E-sd,and E-ratio,and the PW parameters included PI,RI,PSV,and EDV.The pathological results were used as the gold standard to analyze the diagnostic efficacy of blood flow parameters and elastic modulus values for breast lesions,and to explore the correlation between SWE and PW parameters.Results According to the pathological results,the lesions were divided into benign group and malignant group,the results showed that There were significant differences in E-max,E-mean,E-min,E-sd,E-ratio,PI,RI,PSV and EDV between the two groups(P<0.05),while The AUC of E-max and E-sd were the best,which were 0.912 and 0.903,respectively.When E-max>84.45 Kpa was used as the cut-off value,the sensitivity of E-max in the diagnosis of benign and malignant breast lesions was 91.51%.When E-sd>22.35 Kpa was used as the cut-off value,the specificity of E-sd in the diagnosis of benign and malignant breast lesions was 86.38%.When RI>0.70 was used as the cut-off value,the specificity of RI in the diagnosis of benign and malignant breast lesions was 89.00%.When PI>1.07 was used as the cut-off value,the sensitivity of PI in the diagnosis of benign and malignant breast lesions was 85.45%.Correlation analysis showed that E-max was moderately correlated with PI(r=0.793,P<0.05)and RI(r=0.767,P<0.05),and E-sd was moderately correlated with PI(r=0.752,P<0.05)and RI(r=0.731,P<0.05).In the malignant group,there was a correlation between E-max,E-sd and PI,RI,and there was no correlation between the parameters in the benign group.Conclusion The diagnostic performance of SWE and PW parameters for breast lesions is similar,and there is a correlation between SWE and PW parameters in breast lesions,especially in malignant lesions,which can reflect the internal relationship between the elastic characteristics and vascular characteristics of breast lesions.