二维彩超联合SWE在乳腺疾病诊断中的应用价值  

Application value of two-dimensional color Doppler combined with shear wave elastrography in the diagnosis of breast diseases

作　　者：王虹[1,2] 刘佩芳[1] 邵真真[1] 徐熠琳[1] 张宇[1] 朱鹰[1] 

机构地区：[1]天津医科大学肿瘤医院乳腺影像诊断科,国家肿瘤临床医学研究中心,天津市“肿瘤防治”重点实验室,乳腺癌防治教育部重点实验室,300060 [2]天津市黄河医院仪诊科,300110

出　　处：《国际生物医学工程杂志》2015年第2期107-110,I0007,共5页International Journal of Biomedical Engineering

摘　　要：目的探讨二维彩超联合实时剪切波弹性成像（SWE）检查在乳腺疾病诊断中的应用价值。方法选取2013年9月至2014年9月经病理证实的130例（158个）乳腺疾病患者，所有患者均行二维彩超和SWE检查。以受试者操作特性曲线（ROC）得出乳腺良恶性病变最大弹性模量值、平均弹性模量值的相应诊断临界值。依据病理检查结果，分别评价二维彩超和SWE诊断乳腺良恶性病变的敏感性、特异性和准确性，并比较2者的结果。结果130例患者的158个乳腺病灶中，恶性病变90个，良性病变68个。二维彩超和SWE诊断乳腺癌的敏感性分别为89．7％和89．5％；特异性分别为85．6％和95．3％；准确性分别为87．3％和91．4％；二维彩超和SWE2种方法联合检测诊断乳腺癌的敏感性、特异性、准确性分别为98．5％、93．3％、95．6％。结论二维彩超是诊断乳腺良恶性病变的常用检查方法，但是具有一定局限性。SWE检查可提高乳腺良恶性病变诊断的特异性，是传统二维彩超技术的有益补充。二维彩超与定量SWE技术联合应用，显著提高乳腺良恶性病变诊断的敏感性和准确性，为良恶性病变的鉴别诊断提供可靠依据，并且减少漏诊、误诊及不必要的活检，具有重要的临床应用价值。Objective To investigate two-dimensional color Doppler commissure real-time shear wave elastrography （SWE） examination and its application value in the diagnosis of breast diseases. Methods One hundred and thirty patients （158 breast lesions） confirmed with breast disease were chosen from September 2013 to September 2014, and all patients underwent two-dimensional color Doppler ultrasound and SWE examination. The receiver operating characteristic （ROC） curve was examined to obtain maximum elasticity modulus value, average elastic modulus value and the corresponding critical value for the diagnosis of benign and malignant breast lesions. According to the results of pathological examination, sensitivity, specificity and accuracy of two-dimensional ultrasound and SWE for the diagnosis of breast lesions were evaluated and compared. Results Of all 158 breast lesions in 130 patients, 90 were malignant lesions and 68 were benign lesions. The sensitivities of two-dimensional ultrasound and SWE in diagnosis of breast cancer were 89.7% and 89.5%, the specificities were 85.6% and 95.3% and the accuracy were 87.3% and 91.4%, respectively. The sensitivity, specificity and accuracy in the diagnosis of breast cancer by combination of two-dimensional ultrasound and SWE were 98.5%, 93.3%, 95.6%, respectively. Conclusions Although two-dimensional color Doppler uhrasound is a commonly used method in the diagnosis of breast lesions, it has certain limitation. The specificity of diagnosis can be improved by SWE, which is a useful complement to traditional two-dimensional ultrasound technology. Combination of the two methods can significantly increase the sensitivity and accuracy of the diagnosis and provide a reliable basis for the differential diagnosis, reduce the rate of misdiagnosis, missed diagnosis and unnecessary biopsy, which has important clinical application value.

关 键 词：乳腺癌 二维彩超 剪切波 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]