SWE参数Emean临界值和超声BI⁃RADS分类系统对乳腺良恶性病变鉴别诊断效能的ROC曲线影响  

Influence of SWE parameter Emean cutoff value and ultrasound BI⁃RADS classification system on ROC curve of differential diagnosis performance of benign and malignant breast lesions

作　　者：刘贺平 常群英[1] 袁志红[1] Liu Heping;Chang Qunying;Yuan Zhihong(The Third People′s Hospital of Luohe City,Luohe,Henan 462000)

机构地区：[1]漯河市第三人民医院,河南漯河462000

出　　处：《辽宁医学杂志》2023年第5期53-56,共4页Medical Journal of Liaoning

摘　　要：目的探讨实时剪切波弹性成像(SWE)技术联合超声乳腺影像报告和数据系统(BI⁃RADS)分类对乳腺良恶性病变的诊断价值。方法选取128例我院2019年7月~2021年7月就诊的乳腺病变患者,均行常规超声及SWE检查,对常规超声检查结果进行BI⁃RADS分类,以病理检查结果为“金标准”,比较良恶性乳腺病变患者SWE检查参数[最大值(Emax)、平均值(Emean)、最小值(Emin)、弹性比值(Eratio)],ROC曲线分析SWE参数对良恶性病变诊断价值,确定Emean诊断临界值,统计比较超声BI⁃RADS分类、SWE参数Emean临界值单独、联合诊断结果、诊断效能。结果128例乳腺病变患者中,良性54例,恶性74例;与乳腺良性病变患者相比,恶性病变SWE参数Emax、Emean、Emin、Eratio较高(P<0.05);经ROC曲线分析,SWE参数Emean AUC值为0.928,灵敏度为85.14%,特异度为90.74%,优于其他检查参数;与单独超声BI⁃RADS相比,联合诊断特异度96.36%、准确率90.63%较高,误诊率3.63%较低(P<0.05)。结论SWE参数Emean临界值+超声BI⁃RADS分类诊断准确率显著高于单独超声检查,可有效提高诊断效能,对临床早期筛查诊断、制定治疗方案具有重要意义。Objective To investigate the diagnostic value of real⁃time shear wave elastography(SWE)combined with breast imaging reporting and data system(BI⁃RADS)classification for benign and malignant breast lesions.Methods A to⁃tal of 128 patients with breast lesions who were treated in our hospital from July 2019 to July 2021 were selected.All of them underwent routine ultrasound and SWE examination.The results of routine ultrasound examination were classified by BI⁃RADS.The SWE parameters[maximum value(Emax),average value(Emean),minimum value(Emin),and elastic ratio(Eratio)]in patients with benign and malignant breast lesions were compared,and the ROC curve was used to analyze the diagnostic value of SWE parameters for benign and malignant lesions,so as to determine the Emean diagnosis.The critical value was statistically compared with ultrasound BI⁃RADS classification,SWE parameter Emean critical value alone,com⁃bined diagnostic results,and diagnostic efficacy.Results Among the 128 patients with breast lesions,54 were benign and 74 were malignant.Compared with patients with benign breast lesions,the SWE parameters Emax,Emean,Emin and Eratio of malignant lesions were higher(P<0.05).The Emean AUC value was 0.928,the sensitivity was 85.14%,and the speci⁃ficity was 90.74%,which was better than other inspection parameters.Compared with the ultrasound BI⁃RADS alone,the combined diagnosis had a higher specificity of 96.36%,a higher accuracy rate of 90.63%,and a misdiagnosis rate of 3.63%.lower(P<0.05).Conclusion The diagnostic accuracy of SWE parameter Emean threshold value+ultrasound BI⁃RADS classification is significantly higher than that of ultrasound alone,which can effectively improve the diagnostic effi⁃ciency,and is of great significance for early clinical screening and diagnosis and formulation of treatment plans.

关 键 词：剪切波弹性成像 常规超声 乳腺病变 

分 类 号：R445.1[医药卫生—影像医学与核医学] R737.9[医药卫生—诊断学]