剪切波弹性成像技术与超声造影检查对乳腺癌的鉴别诊断价值  

The Value of Shear Wave Elastography and Contrast-enhanced Ultrasound in the Differential Diagnosis of Breast Cancer

作　　者：马新乐[1] 常凤玲[1] 徐杰[1] Ma Xinle;Chang Fengling;Xu Jie(Department of Ultrasound,Xinxiang Central Hospital)

机构地区：[1]新乡市中心医院超声科,453000

出　　处：《长治医学院学报》2021年第2期126-129,共4页Journal of Changzhi Medical College

摘　　要：目的:探讨剪切波弹性成像(SWE)技术联合超声造影(CEUS)检查在鉴别诊断乳腺肿块性质中的应用。方法:选取112例乳腺肿块患者,均经手术病理检查明确病情,均行SWE和CEUS检查。比较良恶性乳腺癌SWE检查病灶弹性杨氏模量值平均值(E_(mean))、最小值(E_(min))、最大值(E_(max))、CEUS检查分值,以手术病理检查为"金标准"比较SWE、CEUS及SWE+CEUS联合检查结果及诊断效能。结果:112例乳腺肿块患者经手术病理检查证实恶性55例,其中浸润性导管癌30例,浸润性小叶癌10例,恶性叶状肿瘤5例,导管原位癌7例,乳头状癌3例;57例良性中纤维瘤21例,导管内乳头状瘤9例,腺病15例,良性叶状肿瘤4例,乳腺炎6例,坏死性淋巴炎2例;恶性肿块SWE检查E_(mean)[(62.37±7.43)vs(21.55±5.32)kPa]、E_(min)[(22.39±5.17)vs(11.09±3.95)kPa]、E_(max)[(103.98±11.05)vs(32.01±6.24)kPa]值大于良性肿块(P<0.05);恶性肿块CEUS检查分值大于良性肿块[(9.01±0.65)vs(4.28±0.24)](P<0.05);SWE联合CEUS检查诊断乳腺癌灵敏度(96.36%)、准确度(93.75%)高于SWE检查、CEUS检查(P<0.05)。结论:SWE联合CEUS检查应用于乳腺肿块性质早期诊断中可提高灵敏度、准确度,降低漏诊率。Objective:To explore the application of shear wave elastography(SWE)combined with contrast-enhanced ultrasound(CEUS)in the differential diagnosis of the nature of breast masses.Methods:A total of 112 patients with breast masses in our hospital were selected and their condition was confirmed by surgical pathological examination.All of them underwent SWE and CEUS examinations.The mean value(E_(mean)),minimum value(E_(min)),maximum value(E_(max))and CEUS scores of Young’s modulus of elasticity in SWE examination of benign and malignant breast cancer were compared.The surgical pathological examination was used as the"gold standard"to compare the results and diagnostic efficacy of SWE,CEUS and SWE+CEUS combined examinations.Results:112 patients with breast masses were confirmed to be malignant by pathological examinations in 55 cases.There were 30 cases of invasive ductal carcinoma,10 cases of invasive lobular carcinoma,5 cases of malignant phyllodes tumor,7 cases of ductal carcinoma in situ,and 3 cases of papillary carcinoma.Among the 57 benign cases,there were 21 cases of fibroids,9 cases of intraductal papilloma,15 cases of adenopathy,4 cases of benign phyllodes tumors,6 cases of mastitis,and 2 cases of necrotizing lymphitis.The E_(mean),E_(min) and E_(max) values of malignant masses in SWE examination were greater than those of benign masses(P<0.05).The CEUS score of malignant masses was greater than that of benign masses(P<0.05).The sensitivity and accuracy of SWE combined with CEUS in the diagnosis of breast masses were higher than those of SWE and CEUS(P<0.05).Conclusion:The application of SWE combined with CEUS examination in the early diagnosis of breast masses can improve the sensitivity and accuracy,and reduce the missed diagnosis rate.

关 键 词：剪切波弹性成像 超声造影 乳腺肿块 准确率 

分 类 号：R445.1[医药卫生—影像医学与核医学]