剪切波弹性成像对乳腺导管内乳头状肿瘤的鉴别诊断价值  

Differential diagnosis value of shear wave elastography in intraductal papillary lesions of breast

作　　者：李程[1] 梁键锋[1] 曾福强[1] 罗平平[1] Li Cheng;Liang Jianfeng;Zeng Fuqiang;Luo Pingping(Department of Ultrasound,Hospital of Traditional Chinese Medicine of Zhongshan,Zhongshan 528400,China)

机构地区：[1]广东省中山市中医院超声科,广东中山528400

出　　处：《中国中西医结合影像学杂志》2020年第2期157-159,171,共4页Chinese Imaging Journal of Integrated Traditional and Western Medicine

基　　金：中山市卫生局医学科研项目(2018A020116)。

摘　　要：目的:评价剪切波弹性成像(SWE)对乳腺导管内乳头状肿瘤的鉴别诊断价值。方法:回顾性分析经病理证实的51例(共58个病灶)乳腺导管内乳头状肿瘤的影像资料。所有病灶在活检前均接受常规超声和SWE检查,记录其超声特征和SWE定量参数。以手术病理结果为金标准,利用ROC曲线下面积(AUC)评价SWE定量参数的诊断性能。结果:SWE参数(杨氏模量值均值Emean、标准差SD及硬度比值Ratio)在良性、不典型或恶性乳头状病变中差异均有统计学意义(均P<0.05)。SWE参数的总体敏感度为54.3%~91.3%,特异度为50.0%~83.3%。Emean的AUC值最高为0.839[95%置信区间(95%CI),0.693~0.985];当Emean的最佳截断值为49.1 kPa时,敏感度为82.6%,特异度为75.0%。结论:SWE定量参数有助于鉴别乳腺导管内乳头状肿瘤。Objective:To evaluate the diagnostic performance of shear wave elastography(SWE)for the differential diagnosis of breast papillary tumors.Methods:Retrospective analysis was performed on 58 lesions in 51 patients with intraductal papillary breast tumors confirmed by pathology.All lesions were examined by conventional ultrasound and SWE before biopsy,and the ultrasonic characteristics and quantitative SWE parameters were recorded for each lesion.The diagnostic performance of quantitative SWE parameters was evaluated by using AUC with the gold standard of surgical pathological results.Results:SWE parameters(Emean,SD and Ratio)showed significant differences in the differential diagnosis of benign,atypical or malignant papillary lesions(all P<0.05).The overall sensitivity of SWE parameters was 54.3%~91.3%,and the specificity was 50.0%~83.3%.The highest AUC value of Emean was 0.839(95%CI 0.693~0.985).When the optimal truncation value of Emean was 49.1 kPa,the sensitivity was 82.6%and the specificity was 75.0%.Conclusions:SWE provides additional information for the differential diagnosis of breast papillary tumors.Quantitative SWE features are helpful to differentiate breast papillary lesions.

关 键 词：超声检查 弹性成像 乳腺肿瘤 真空辅助旋切系统 

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