剪切波弹性成像参数对乳腺肿块的鉴别价值及与临床病理学特征的相关性分析  

The value of shear wave elastography parameters in the identification of breast mass and their correlation with clinicopathological features

作　　者：李艳[1] 栾宇婷 常静瑄 张翠明[1] 杨小欢[1] LI Yan;LUAN Yuting;CHANG Jinxuan;ZHANG Cuiming;YANG Xiaohuan(Department of Ultrasound,The Second Hospital of Shanxi Medical University,Taiyuan 030001,Shanxi Province,China)

机构地区：[1]山西医科大学第二医院超声科,山西太原030001

出　　处：《肿瘤影像学》2023年第6期506-511,共6页Oncoradiology

基　　金：山西省基础研究计划(自由探索类)项目(20210302123262)。

摘　　要：目的:分析剪切波弹性成像(shear wave elastography,SWE)定量参数及定性参数对乳腺良恶性肿块的诊断效能,探讨其与乳腺癌的临床病理学参数间的相关性。方法:选取经病理学检查确诊92例乳腺肿块患者(共112个肿块),获取肿块SWE定量参数及定性参数,同时记录患者的临床病理学资料。比较良恶性肿块SWE参数的差异性,绘制受试者工作特征(receiver operating characteristic,ROC)曲线,采用Z检验分析SWE参数对乳腺肿块良恶性的诊断效能,并用Spearman秩相关分析法分析其与临床病理参数间的相关性。结果:乳腺恶性肿块的弹性最大值(E_(max))、弹性平均值(E_(mean))均高于良性肿块[E_(max):72.46(55.73,89.98)kPa vs 197.73(104.62,266.77)kPa;E_(mean):31.32(20.43,54.09)kPa vs 100.40(75.36,119.40)kPa]。SWE图像分型中,乳腺良性肿块多为Ⅰ、Ⅱ、Ⅲ型,恶性肿块多为Ⅳ、Ⅴ型,差异有统计学意义(P=0.000)。E_(max)、E_(mean)及SWE图像分型用于区分乳腺良恶性肿块的曲线下面积(area under curve,AUC)分别为0.918、0.892、0.906,但差异无统计学意义(P>0.05),三者联合诊断肿块性质与单独诊断相比,具有最大诊断效能(AUC=0.957),差异有统计学意义(P<0.01)。SWE各参数与乳腺癌肿块直径、淋巴结状态、临床分期呈正相关(P<0.05),此外,SWE定量参数与肿块人表皮生长因子受体2(human epidermal growth factor 2,HER2)的表达及组织学分级呈正相关(P<0.05)。结论:SWE参数对乳腺良恶性肿块具有一定的鉴别价值,且与乳腺癌部分临床病理学特征具有一定相关性。Objective:To analyze the diagnostic efficacy of quantitative and qualitative parameters of shear wave elastography(SWE)in benign and malignant breast masses,and to predict the malignant degree of breast cancer by exploring the correlation between SWE and clinicopathological parameters of breast cancer.Methods:A total of 92 patients with pathologically confirmed breast masses(112 masses in total)were selected.The quantitative and qualitative parameters of SWE were obtained,and the clinicopathological data of the patients were recorded.The differences of SWE parameters between benign and malignant breast masses were compared,and the receiver operating characteristic(ROC)curve was drawn.Z test was used to analyze the diagnostic efficacy of SWE parameters in differentiating benign and malignant breast masses,and Spearman rank correlation analysis was used to explore the correlation between SWE parameters and clinicopathological parameters.Results:The maximum value(E_(max))and average value(E_(mean))of malignant breast mass were higher than those of benign breast mass[E_(max):72.46(55.73,89.98)kPa vs 197.73(104.62,266.77)kPa;E_(mean):31.32(20.43,54.09)kPa vs 100.40(75.36,119.40)kPa].In SWE image classification,benign masses were mostly typeⅠ,ⅡandⅢ,while malignant masses were mostly typeⅣandⅤ,the difference was statistically significant(P=0.000).The area under the curve(AUC)of E_(max),E_(mean)and SWE classification for differentiating malignant and benign masses were 0.918,0.892 and 0.906,respectively,but the difference was not statistically significant(P>0.05).The combination of the three had the largest area under curve(AUC=0.957)and the highest diagnostic efficacy,compared with E_(max),E_(mean)and SWE classification,and the difference was statistically significant(P<0.05).All SWE parameters were positively correlated with tumor diameter,lymph node status and clinical stage of breast cancer(P<0.05).In addition,SWE quantitative parameters were positively correlated with human epidermal growth factor 2(HER2)e

关 键 词：乳腺肿块 超声 剪切波弹性成像 临床病理学 

分 类 号：R736.1[医药卫生—肿瘤] R445.1[医药卫生—临床医学]