剪切波弹性成像联合CEUS校正乳腺影像报告和数据系统3～5类乳腺病变  

Combination of shear wave elastography and CEUS in correction of BI-RADS classification 3—5 grade breast lesions

作　　者：戚敏 姜学忠[3] 李嘉[1,2] 王颖彦[2] 沈会明[2] 高亚琴[2] 胡中倩[2] QI Min;JIANG Xuezhong;LI Jia;WANG Yingyan;SHEN Huiming;GAO Yaqin;HU Zhongqian(School of Medicine,Southeast University,Nanjing 210009,China;Department of Ultrasound,Zhongda Hospital,Southeast University,Nanjing 210009,China;Department of Ultrasound,Jiangsu Province Geriatric Hospital,Nanjing 210846,China)

机构地区：[1]东南大学医学院,江苏南京210009 [2]东南大学附属中大医院超声科,江苏南京210009 [3]江苏省老年医院超声科,江苏南京210846

出　　处：《中国医学影像技术》2018年第10期1509-1513,共5页Chinese Journal of Medical Imaging Technology

基　　金：江苏省卫生计生委课题(H201534)

摘　　要：目的探讨剪切波弹性成像(SWE)联合CEUS在校正乳腺影像报告和数据系统(BI-RADS)3~5类乳腺肿瘤中的应用价值。方法收集50例乳腺病变患者(57个病灶),其中良性病灶28个,恶性29个。对所有病灶术前行常规超声、SWE和CEUS检查,以常规超声进行BI-RADS分类,并采用SWE、CEUS及SWE联合CEUS对BI-RADS分类进行校正。以病理结果为金标准,计算常规超声、SWE、CEUS及SWE联合CEUS诊断乳腺良恶性病灶的敏感度、特异度和诊断正确率。结果 SWE参数最大杨氏模量值(E_(max))诊断乳腺良恶性病灶的临界值为87.2kPa,CEUS的临界值为8.5分,SWE联合CEUS的多因素Logistic回归模型为Y(P)=-18.785+0.161X_1+11.822X_2,X_1为E_(max),X_2为增强后病灶大小改变。SWE联合CEUS将11个病灶正确降为3级,4个病灶误诊;SWE联合CEUS诊断乳腺良恶性病灶的敏感度特异度和诊断正确率分别为100%(29/29)、85.71%(24/28)和92.98%(53/57)。结论SWE联合CEUS对BI-RADS3～5类乳腺病灶具有良好的校正作用,可提高超声诊断正确率。Objective To observe the value of shear wave elastography(SWE)combined with CEUS in the correction of breast imaging reporting and data system(BI-RADS)classification 3-5 grade breast lesions.Methods Totally 50 patients with 57 breast lesions were enrolled,including 28 benign lesions and 29 malignant ones.Conventional ultrasound,SWE and CEUS were performed preoperatively,and the BI-RADS grade was classified with conventional ultrasound,and was corrected with SWE,CEUS and the combination of these 2 methods.Taking pathologic results as golden standards,the sensitivity,specificity and diagnostic accuracy of conventional ultrasound,SWE,CEUS and combination of the latter two in diagnosis of benign and malignant breast lesions were calculated.Results The threshold of SWE parameter maximum Young's modulus value(E max)was 87.2 kPa,of CEUS was 8.5 points,the multivariate Logistic regression model was Y(P)=-18.785+0.161X 1+11.822X 2,with E max of X 1 and the size of enhanced lesion of X 2.Eleven lesions were downgraded with the regression model,and 4 lesions were misdiagnosed.The sensitivity,specificity and diagnostic accuracy were 100%(29/29),85.71%(24/28)and 92.98%(53/57)in diagnosis of benign and malignant breast lesions.Conclusion Combination of SWE and CEUS has great value in the correction of BI-RADS classification 3-5 grade breast lesions and may improve the diagnostic accuracy.

关 键 词：弹性成像技术 超声检查 造影剂 Logistic模型 乳腺影像报告和数据系统 

分 类 号：R737.9[医药卫生—肿瘤] R445.1[医药卫生—临床医学]