剪切波弹性成像彩色图像评分法诊断良恶性乳腺实性病变  

Color image scoring system of shear wave elastography in differential diagnosis of benign and malignant solid breast masses

作　　者：曾庆劲[1] 曾婕[1] 吴涛[1] 苏中振[1] 郑剑[1] 张红君[1] 郑荣琴[1] 

机构地区：[1]中山大学附属第三医院超声科,广东广州510630

出　　处：《中国医学影像技术》2015年第3期405-408,共4页Chinese Journal of Medical Imaging Technology

基　　金：广东省医学科学技术研究基金(B2014148)

摘　　要：目的探讨剪切波弹性成像(SWE)彩色弹性图像评分法在乳腺实性病变良恶性诊断中的价值。方法对经病理确诊的151例乳腺实性病变女性患者(共212个病灶)行SWE检查。采用图像类型评分法及图像颜色评分法获得半定量分值,以手术病理结果为金标准构建ROC曲线,评价两种方法诊断乳腺实性病变良恶病灶的差异。结果病理诊断良性103例(160个病灶),恶性48例(52个病灶)。乳腺良恶性病变间类型评分法评分、颜色评分法评分的差异均有统计学意义(P均<0.0001);ROC曲线下面积分别为0.882、0.913,二者差异有统计学意义(χ2=2.101,P=0.04);类型评分法与颜色评分法对良恶性病灶的鉴别诊断具有良好的相关性(r=0.898,P<0.01)。SWE彩色图像类型评分法以>2分、颜色评分法以>2分为诊断界值时,敏感度、特异度、阳性似然比、阴性似然比、阳性预测值、阴性预测值分别为84.62%(44/52)、87.50%(140/160)、6.77、0.18、68.75%(44/64)、94.59%(140/148)和82.69%(43/52)、90.63%(145/160)、8.82、0.19、74.14%(43/58)、94.20%(145/154)。结论 SWE彩色弹性图像评分法对乳腺实性病变良恶性病灶具有较高的诊断价值,可作为乳腺实性病变良恶性鉴别简便、有效的方法,SWE彩色图像颜色评分法诊断效能优于类型评分法。Objective To evaluate the value of color image scoring system of shear-wave elastography（SWE）in differential diagnosis of benign and malignant solid breast masses.Methods Totally 151 female patients with 212 pathologically confirmed breast masses underwent SWE.The semi-quantitative scores were obtained by SWE pattern scoring system and SWE color scoring system.With the pathologic results as references,ROC curves were used to assess diagnostic value,and the differences of two SWE scoring system were investigated.Results There were 160 benign lesions in 103 patients,and52malignant lesions in 48 patients.The differences of SWE pattern score and color score between benign lesions and malignant lesions were statistically significant（all P〈0.0001）.The area under the ROC curve（Az）of the SWE pattern scoring system and SWE color scoring system was 0.882 and 0.913,respectively.The difference was statistically significant（χ^2=2.101,P=0.04）.There was good correlation between the two scoring systems in differential diagnosis of benign and malignant solid breast masses（r=0.898,P〈0.01）.With the score 2as the threshold of the SWE pattern scoring system and color scoring system,the sensitivity,specificity,positive likelihood ratio,negative likelihood ratio,positive predictive value,negative predictive value was 84.62%（44/52）,87.50%（140/160）,6.77,0.18,68.75%（44/64）,94.59%（140/148）and 82.69%（43/52）,90.63%（145/160）,8.82,0.19,74.14%（43/58）,94.20%（145/154）,respectively.Conclusion SWE color image scoring system has high value in differential diagnosis of benign and malignant solid breast masses,which can be used as a simple and effective diagnosis method.SWE color scoring system is more valuable.

关 键 词：乳腺肿瘤 超声检查 弹性成像技术 诊断 

分 类 号：R445.1[医药卫生—影像医学与核医学] R737.9[医药卫生—诊断学]