剪切波弹性成像技术联合超声BI-RADS分类鉴别诊断乳腺良恶性病变的价值  

The Value of Shear Wave Elastography Combined with Ultrasound BI-RADS Category in Differential Diagnosis of Breast Benign and Malignant Lesions

作　　者：陈继赵 谢春梅 孙希文[2] CHEN Ji-zhao;XIE Chun-mei;SUN Xi-wen(Department of Ultrasound,North Huashan Hospital,Fudan University;Department of Radiology.Shanghai Pulmonary Hospital,Tongji University,Shanghai 201906,P.R.C.)

机构地区：[1]复旦大学附属华山医院北院超声医学科 [2]同济大学附属上海市肺科医院放射科,上海市201906

出　　处：《中国医学计算机成像杂志》2020年第4期359-363,共5页Chinese Computed Medical Imaging

基　　金：院内科研启动基金NO.HSBY2019014。

摘　　要：目的:探讨剪切波弹性成像(SWE)技术联合超声乳腺影像报告和数据系统(BI-RADS)分类鉴别诊断乳腺良恶性病变的价值。方法:选取2018年10月至2019年6月在我院就诊的115例病变患者(132个病灶)为研究对象,先进行常规超声检查,对病灶进行BI-RADS分类,再行剪切波弹性成像检测,获得剪切波定量参数,以病理结果为金标准,构建受试者工作特征(ROC)曲线,评价SWE参数Emean、Esd、Eratio的诊断价值,并对4A类病灶进行校正。结果:应用BI-RADS分类诊断乳腺良恶性病变的敏感度、特异度、准确度、阳性预测值分别为100.00%、70.93%、81.06%、64.79%,SWE定量参数Emean临界值为40.5kPa,其诊断乳腺良恶性病变的敏感度、特异度、准确度、阳性预测值分别为80.43%、93.02%、88.64%、86.05%,SWE参数Emean临界值联合超声BI-RADS诊断乳腺诊断乳腺良恶性病变的敏感度、特异度、准确度、阳性预测值分别为100.00%、88.37%、92.42%、82.14%。结论:超声剪切波弹性成像技术联合超声BI-RADS分类可提高乳腺癌诊断的准确度,对4A类病灶进行校正,可减少不必要的穿刺活检或手术。Purpose:To discuss the value of shear wave elastography(SWE)combined with ultrasound BI-RADS category in differential diagnosis of breast benign and malignant lesions.Methods:One hundred and thirty-two lesions in 115 patients who visited our out-patient department during October 2018 and June 2019 were chosen as the objects of the study.Routine ultrasound examinations were first done in order to get the BI-RADS category of lesions.Then SWE exam was done to obtain quantitative parameters.ROC curve was built by the golden standard of the pathological results.The diagnostic value of Emean,Esd,Eratio,parameters of SWE,were evaluated and the lesions category of 4A were adjusted from that.Results:The sensitivity,specificity,accuracy,positive predictive value of the diagnosis of breast benign and malignant lesions based on BI-RADS,were 100%,70.93%,81.06%,64.79%,75%,respectively.When Emean threshold was set as 40.5kPa,the sensitivity,specificity,accuracy,positive predictive value of SWE in diagnosing breast benign and malignant lesions were 100%,70.93%,81.06%,64.79%,75%,respectively.When Emean threshold combined with ultrasound BI-RADS to diagnose breast lesions,the sensitivity,specificity,accuracy,positive predictive were 100.00%,88.37%,92.42%,82.14%,respectively.Conclusion:Shear wave elastography combined with ultrasound BI-RADS category is able to increase the accuracy of breast cancer diagnosis.The unnecessary biopsy and surgery may be avoided if the lesions category of 4A could be adjusted through it.

关 键 词：剪切波弹性成像 乳腺影像报告和数据系统 乳腺病变 

分 类 号：R445.1[医药卫生—影像医学与核医学]