剪切波弹性成像联合超声加权评分法对乳腺肿块诊断的应用价值  

The application value of shear wave elastography combined withultrasound weighted scoring method in the diagnosis of breast mass

作　　者：袁莹莹 任毅[2] 孔丹 何莉莉 陈孑孑 张晓丹 YUAN Yingying;REN Yi;KONG Dan;HE Lili;CHEN Jiejie;ZHANG Xiaodan(Department of Ultrasound,The Affiliated Huaian No.1 People s Hospital of Nanjing Medical University,Huaian 223300,Jiangsu,China;Department of Thyroid and Breast Surgery,The Affiliated Huaian No.1 People s Hospital of Nanjing Medical University,Huaian 223300,Jiangsu,China;Imaging Center,The Affiliated Huaian No.1 People s Hospital of Nanjing Medical University,Huaian 223300,Jiangsu,China)

机构地区：[1]南京医科大学附属淮安第一医院超声科,江苏淮安223300 [2]南京医科大学附属淮安第一医院甲乳外科,江苏淮安223300 [3]南京医科大学附属淮安第一医院影像中心,江苏淮安223300

出　　处：《暨南大学学报（自然科学与医学版）》2023年第4期392-398,共7页Journal of Jinan University(Natural Science & Medicine Edition)

基　　金：江苏省卫健委科研项目(H2019048)。

摘　　要：目的:探讨剪切波弹性成像(SWE)联合超声加权评分法对乳腺肿块诊断的应用价值。方法:回顾性选取2018年5月至2020年5月本院收治的120例乳腺肿块患者作为研究对象,其中良性组62例,恶性组58例。两组均行乳腺常规超声和SWE检查,比较两组SWE最大值、SWE最小值、平均值和超声加权评分,并采用ROC曲线分析剪切波弹性成像评分联合超声加权评分法对乳腺肿块的诊断效能。结果:乳腺超声加权评分恶性组为(7.97±4.01)分,明显高于良性组(4.48±2.34)分(t=5.771,P<0.05);超声加权评分和SWE联合超声加权评分对乳腺肿块分级的诊断两组结果比较,差异无统计学意义(P>0.05)。SWE最大值、SWE平均值良性组低于恶性组(P<0.05);两组SWE最小值比较,差异无统计学意义(P>0.05);二元Logistic回归分析结果提示,SWE最大值、SWE平均值及超声加权评分均为乳腺良恶性肿块的影响因素(P<0.05);ROC曲线分析显示,联合SWE最大值、SWE平均值和超声加权评分法诊断乳腺肿块的AUC为0.931,高于超声加权评分法的0.763,SWE最大值的0.799,SWE平均值的0.769(Z分别为4.188;3.241;3.938,P<0.05)。结论:剪切波弹性成像评分联合超声加权评分法可提高乳腺肿块诊断的准确度,有助于乳腺癌的早期筛查诊断。Objective:To explore the application value of shear wave elastography(SWE)combined with ultrasound weighted score in the diagnosis of breast lumps.Methods:A total of 120 patients with breast mass admitted to our hospital from May 2018 to May 2020 were retrospectively selected as research objects,including 62 cases with benign lesions in benign group and 58 cases with malignant lesions in malignant group.All underwent routine breast ultrasound examination and SWE.The maximum SWE,minimum SWE,mean SWE and ultrasound weighted score of the two groups were compared,and ROC curve was used to analyze the diagnostic efficiency of shear wave elastic imaging score combined with ultrasound weighted score in the diagnosis of breast mass.Results:The ultrasound weighted score of the malignant group was(7.97±4.01)points,which was significantly higher than that of the benign group(4.48±2.34)points(t=5.771,P<0.05).There was no significant difference between ultrasound weighted score and SWE combined ultrasound weighted score in the diagnosis of breast lumps(P>0.05).The maximum and mean values of SWE in benign group were lower than those in malignant group(P<0.05).There was no significant difference in the minimum value of SWE between the two groups(P>0.05).Binary Logistic regression analysis showed that the maximum value of SWE,the average value of SWE and the weighted score of ultrasound were the factors affecting benign and malignant breast masses(P<0.05).ROC curve analysis showed that the AUC of maximum SWE,mean SWE and ultrasound-weighted score was 0.931,higher than that of ultrasound-weighted score(0.763),maximum SWE(0.799)and mean SWE(0.769)(Z=4.188;Z=3.241;Z=3.938,P<0.05).Conclusion:Shear wave elastic imaging score combined with weighted ultrasound score can improve the accuracy of breast mass diagnosis and contribute to the early screening and diagnosis of breast cancer.

关 键 词：乳腺肿块 剪切波弹性成像 超声加权评分法 

分 类 号：R445[医药卫生—影像医学与核医学] R737.9[医药卫生—诊断学]