剪切波弹性成像与超声点状强回声计数法诊断侵袭性基底细胞癌的对比研究  

Comparative study of shear wave elastography and ultrasonic hyperechoic spots counting method in the diagnosis of invasive basal cell carcinoma

作　　者：梁键锋[1] 李程[1] 陆俊名 吴汉辉[1] 詹德瑞 董月珍 LIANG Jianfeng;LI Cheng;LU Junming;WU Hanhui;ZHAN Derui;DONG Yuezhen(Department of Ultrasound,Hospital of Traditional Chinese Medicine of Zhongshan,Guangdong 528400,China)

机构地区：[1]广东省中山市中医院超声科,528400

出　　处：《临床超声医学杂志》2021年第11期863-866,共4页Journal of Clinical Ultrasound in Medicine

基　　金：中山市第一批社会公益与基础研究项目(医疗卫生)(2020B1078)。

摘　　要：目的对比剪切波弹性成像(SWE)与超声点状强回声计数法诊断侵袭性基底细胞癌(BCC)的价值。方法选取我院皮肤科经手术病理确诊的BCC患者95例,根据病理亚型将其分成侵袭性BCC 15例与非侵袭性BCC 80例,术前均应用SWE检测二者病灶杨氏模量平均值,并对其进行比较;绘制受试者工作特征曲线分析其诊断BCC侵袭性的截断值,比较SWE与超声点状强回声计数法鉴别BCC侵袭性的诊断效能。结果侵袭性BCC杨氏模量平均值为(32.7±11.2)kPa,非侵袭性BCC杨氏模量平均值为(25.6±5.1)kPa,二者比较差异有统计学意义(P=0.001)。当杨氏模量平均值截断值为25.7 kPa时,鉴别侵袭性BCC的敏感性、特异性和准确率分别为86.7%、85.0%和80.0%;超声最大切面点状强回声计数≥7个时,鉴别侵袭性BCC的敏感性、特异性和准确率分别为60.0%、61.8%和61.1%。SWE鉴别BCC的敏感性、特异性和准确率均优于超声点状强回声计数法,差异均有统计学意义(均P<0.05)。结论SWE在诊断侵袭性BCC方面优于超声点状强回声计数法。Objective To compare the value of shear wave elastography(SWE)and ultrasonic hyperechoic spots counting method in the diagnosis of invasive basal cell carcinoma(BCC).Methods A total of 95 patients with BCC confirmed by surgical pathology in the department of dermatology from our hospital were selected,and further divided into invasive BCC(15 cases)and non-invasive BCC(80 cases)according to pathological subtypes.The mean value of Young’s modulus of lesions was measured by SWE before surgery,the results was compared.The cut-off value for the diagnosis of BCC invasiveness was analyzed by drawing the receiver operating characteristic curves.The diagnostic efficacy of SWE and ultrasound hyperechoic spots counting method in identifying BCC invasiveness was compared.Results The mean Young’s modulus of invasive BCC was(32.7±11.2)kPa,and that of non-invasive BCC was(25.6±5.1)kPa,there was statistically significant difference(P=0.001).When the mean cut-off value of Young’s modulus was 25.7 kPa,the sensitivity,specificity and accuracy of the diagnosis of BCC invasion were 86.7%,85.0%and 80.0%,respectively.When the number of ultrasound hyperechoic spots counting≥7,the sensitivity,specificity and accuracy of the diagnosis of BCC invasion were 60.0%,61.8%and 61.1%,respectively.The sensitivity,specificity and accuracy of SWE for identifying invasive BCC were higher than those of ultrasound hyperechoic spots counting,and the differences were statistically significant(all P<0.05).Conclusion The value of SWE in the diagnosis of invasive BCC is better than that of ultrasound hyperechoic spots counting method.

关 键 词：剪切波弹性成像 超声检查 基底细胞癌 侵袭性 杨氏模量 

分 类 号：R445.1[医药卫生—影像医学与核医学] R730.261[医药卫生—诊断学]