实时剪切波弹性成像鉴别乳腺肿瘤良恶性的初步探讨  

Differential diagnosis of benign and malignant breast tumors by SWE

作　　者：林武辉[1] 何立红[1] 黎见 赖胜坤[1] 

机构地区：[1]广东省中山市博爱医院超声科,广东中山528403

出　　处：《中国中西医结合影像学杂志》2016年第3期263-265,共3页Chinese Imaging Journal of Integrated Traditional and Western Medicine

摘　　要：目的 :探讨实时剪切波弹性成像技术(shear wave elastography,SWE)对乳腺肿块良恶性的鉴别诊断价值。方法 :选择我院行乳腺彩色多普勒超声和SWE检查检出乳腺肿块且经手术病理证实的女性患者54例,共72个乳腺肿块,对其SWE图像进行回顾性分析。应用ROC曲线确定SWE判断乳腺恶性肿瘤的最佳指标,获得其最佳诊断界值。结果:1乳腺良性肿瘤SWE典型表现:蓝色为主,颜色分布均匀;恶性肿瘤SWE典型表现:红色为主,颜色分布较杂乱。2与良性肿瘤相比,恶性肿瘤的平均弹性模量值(Emean)、标准差(SD)、与周边正常乳腺组织弹性模量的比值(Ratio)均明显增加,差异均有统计学意义(均P<0.01)。3以病理结果为金标准,绘制SWE技术参数Emean、SD、Ratio的ROC曲线,其曲线下面积分别为0.933、0.891和0.753,表明Emean是诊断乳腺恶性肿瘤的最佳指标,截断值为46.41 k Pa。结论:SWE可定量测定乳腺肿块的弹性模量值,为乳腺肿块的良恶性鉴别诊断提供依据。Objective：To evaluate the diagnostic value of shear wave elastography（SWE） in differential diagnosis of benign and malignant breast tumors. Methods：From January to September 2015,SWE was performed in 72 breast lesions of 54 female patients with pathologically confirmed results,to obtain the elastic modulus（mean,SD and Ratio） of breast lesions. ROC curve were plotted to determine the most accurate SWE value and the cut-off value for differential diagnosis. Results：1The typical image of the benign tumors was mainly blue with uniform color,while the typical image of the malignant tumors was mainly red and the color clutter. 2Compared with the benign tumors,the average modulus of elasticity（Emean）,standard deviation（SD）,and the ratio of the elastic modulus（Ratio） of the normal breast tissue were significantly increased（P〈0.01）. 3The area under the ROC curve（AUC） of Emean,SD and Ratio were 0.933、0.891 and 0.753,respectively,which means that the Emean value in the nodule was the best value in comparison with other SWE values. The cut-off value was 46.41 k Pa. Conclusions：SWE has good diagnostic performance on distinguishing malignant breast tumors from benign.

关 键 词：乳腺肿瘤 超声检查 弹性成像技术 

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]