剪切波弹性成像与超声造影联合评分对乳腺病灶定性诊断的临床研究  

Clinical study on the diagnosis of breast lesions by shear wave elastography combined with contrast-enhanced ultrasound

作　　者：戚敏 王颖彦[1] 沈会明[1] 高亚琴[1] 胡中倩[1] 李嘉[1] QI Min;WANG Yingyan;SHEN Huiming;GAO Yaqin;HU Zhongqian;LI Jia(Department of Ultrasound,Zhongda Hospital Affiliated to Southeast University,Nanjing 210009,China)

机构地区：[1]东南大学附属中大医院超声诊断科,江苏南京210009

出　　处：《南京医科大学学报（自然科学版）》2021年第2期258-261,285,共5页Journal of Nanjing Medical University(Natural Sciences)

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联合超声造影对乳腺病灶定性诊断的临床价值。方法:选取2016年1月-2018年9月在本院超声诊断科就诊158例患者的170个病灶,收集术前同时行常规超声、剪切波弹性成像及超声造影检查的结果,以病理为金标准构建受试者工作特征曲线(receiver operating characteristic curve,ROC),比较各种方法对乳腺病灶良恶性判断的诊断效能,并分析漏诊及误诊病例。结果:根据ROC曲线得到剪切波弹性成像、超声造影单独评分及两者联合的诊断效能,剪切波弹性成像的诊断敏感度、特异度、准确度及曲线下面积分别为85.96%、75.00%、82.35%、0.807,超声造影单独评分法为94.74%、71.43%、87.06%、0.833,两者联合评分法为97.37%、75.00%、90.00%、0.864,两者联合评分法的诊断效能最大。结论:剪切波弹性成像联合超声造影可提高乳腺病灶的诊断效能,对乳腺病灶的良、恶性鉴别诊断具有重要价值。Objective:This study aims to investigate the clinical value of shear wave elastography combined with contrast-enhanced ultrasound in the diagnosis of breast lesions. Methods:There were 159 patients,a total of 171 breast lesions enrolled by ultrasound in our hospital from January 2016 to September 2018. The conventional ultrasound,shear wave elastography and contrast-enhanced ultrasound were performed before operation. Taking the pathology as the golden standard,and the ROC curve was drawn. The diagnostic efficacy of conventional BI-RADS classification,shear wave elastography,contrast-enhanced ultrasound and the joint score in the diagnosis of benign and malignant breast lesions were compared,and the clinical value of shear wave elastography combined with contrast-enhanced ultrasound in the diagnosis of breast lesions was summarized. Results:According to the ROC curve,the diagnostic value of shear wave elastography,contrast-enhanced ultrasound and the joint method were obtained,respectively. The diagnostic sensitivity,specificity,accuracy and area under the curve of single method were 85.96%,75.44%,82.46%,0.807;94.74%,71.93%,87.13%,0.833 and 97.37%,75.44%,90.05%,0.864,respectively. The combination has the highest detection rate of malignancy and the highest diagnostic efficiency. Conclusion:Shear wave elastography combined with contrast-enhanced ultrasound improves the diagnostic efficacy of breast lesions and has great diagnostic value for benign and malignant breast tumors.

关 键 词：乳腺病灶 BI-RADS分类 剪切波弹性成像 超声造影 

分 类 号：R445.1[医药卫生—影像医学与核医学]