多中心研究：弹性应变率比值对弹性评分法评估乳腺病灶良恶性的辅助价值探讨  

A multicenter study to confirm further diagnostic value of strain ratio method giving to 5-point scoring by elastography for differentiation of breast lesions

作　　者：欧冰[1] 吴嘉仪[1] 周薪传[1] 姚继祎[1] 梁铭[1] 罗葆明[1] 智慧[1] 彭玉兰[2] Shyam Sunder Parajuly 王怡 许萍 柳莉莎[4] 郝翼 肖莹[5] 刘守军 李靖 吴长君[7] 姜玉新[8] 

机构地区：[1]中山大学孙逸仙纪念医院超声科,广州510120 [2]四川大学华西医院超声科 [3]复旦大学附属华山医院超声科 [4]新疆医科大学肿瘤医院超声科 [5]中南大学湘雅医院超声科 [6]中国医科大学盛京医院超声科 [7]哈尔滨医科大学附属第一医院超声科 [8]北京协和医院超声科

出　　处：《中华超声影像学杂志》2017年第10期867-871,共5页Chinese Journal of Ultrasonography

摘　　要：目的探讨弹性成像应变率比值对改良弹性评分法评估乳腺良恶性病灶的辅助价值。方法通过对多中心收集的已行常规超声检查和弹性成像检查的846例患者（1071个病灶）超声影像资料进行回顾性分析，结合病理结果，评价应变率比值法对改良弹性评分法对乳腺良恶性病灶评估的辅助价值。结果512例恶性病灶的应变率比值为8．1±5．9，559例良性病灶的应变率比值为2．7±1．4，其差异有统计学意义（P〈0．001）。当应变率比值法诊断界点为3．03时，敏感性为81．6％，特异性为89．7％，准确性为81．7％，阳性预测值为80．2％，阴性预测值为84．2％。弹性评分法与应变率比值法ROC曲线下的面积（AUC）分别为0．862、0．865（P=0．622）。对于3～4分病灶弹性评分法与应变率比值法的AUC分别为0．629、0．711（P=0．020）。结论本研究中，改良弹性评分法与应变率比值法总体上具有相同的诊断表现，但对于3～4分的病灶，应变率比值法具有更高的诊断效能，对于弹性评分法正确诊断乳腺病灶具有一定的辅助价值。Objective To confirm whether strain ratio should be added after evaluation of lesions with 5-point elasticity scoring for differentiating breast lesions on ultrasonic elastography （UE）. Methods Eight hundred and forty-six consecutive female patients with 1 071 breast lesions were recruited into a multicenter retrospective study,which involved 8 centers across China. All the patients underwent the UE procedure and the strain ratios were calculated. The sensitivity, specificity, accuracy, PPV and NPV were calculated for each of the two evaluation systems and the areas under the ROC curve were compared. Results The strain ratios of 559 benign lesions （2.7 ±1.4） and 512 malignant lesions （8.1 ±5.9） were significantly different （P〈0.001）. When the cutoff point was 3.03, strain ratio method had 81.6% sensitivity, 89.7% specificity, 81.7% accuracy, 80.2% PPV and 84.2 % NPV. The areas under the ROC curve with the strain ratio method and 5-point scoring method were 0. 865 and 0. 862, respectively （ P = 0. 622）. For the lesions with elasticity score 3 and 4, the areas under the ROC curve of the two methods were 0.711 and 0.629, respectively （P = 0.020 ）. Conclusions Although the two UE methods have similar diagnostic performance, separate calculation of the strain ratios seems compulsory, especially for the lesions with elasticity score 3 and 4.

关 键 词：弹性成像技术 乳腺疾病 应变率比值 弹性评分 

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]