改良法间断加压式应变弹性成像在提高乳腺结节弹性成像图像稳定性及结节良恶性鉴别能力中的应用价值  

The Application Value of Improved Intermittent Compression Strain Elastography in Improving Stability of Breast Elastography and Ability to Distinguish Benign and Malignant Nodules

作　　者：亢庆文 黄道中 赵莹 冯群群 Kang Qingwen;Huang Daozhong;Zhao Ying(Department of Ultrasound,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China)

机构地区：[1]华中科技大学同济医学院附属同济医院超声影像科,武汉430030

出　　处：《华中科技大学学报（医学版）》2023年第6期858-862,共5页Acta Medicinae Universitatis Scientiae et Technologiae Huazhong

摘　　要：目的探讨改良法间断加压式应变弹性成像(improved intermittent compression strain elastography,IICSE)对提高乳腺结节弹性成像图像稳定性及良恶性结节鉴别能力的应用价值。方法选择华中科技大学同济医学院附属同济医院收治的乳腺疾病患者113例共138个乳腺结节,术前1周进行高频彩超、IICSE和非间断加压式应变弹性成像(nonintermittent compression strain elastography,NCSE)检查,比较IICSE和NCSE前3次均能得到一致的弹性结果的概率,并绘制IICSE、NCSE弹性评分鉴别乳腺良恶性病灶的受试者工作特征(ROC)曲线,计算曲线下面积(AUC),选取AUC面积较大者对BI-RADS分类进行调整,比较高频彩超与高频彩超联合IICSE诊断不同BI-RADS分类的乳腺良恶性病灶的差异及对不同BI-RADS分类结节构成比的差异。结果IICSE操作前3次得到弹性结果的一致率远大于NCSE(90.6%vs.34.8%,P<0.05);ROC曲线显示IICSE的曲线下面积(AUC)大于NCSE(0.865 vs.0.636,P<0.05);高频彩超联合IICSE前后相比,联合后诊断结果中BI-RADS 3类和5类结节的例数明显增加,BI-RADS 4类结节例数减少(均P<0.05)。结论IICSE在一定程度上改善了常规弹性成像稳定性较低的问题;同时,IICSE使需要进一步检查的患者人数减少,在一定程度上减少了医疗资源的浪费。Objective To investigate the application value of improved intermittent compression strain elastography in improving the image stability of breast elastography and the identification ability of benign and malignant nodules.Methods In all,113 patients(138 breast lesions)were recruited in this study,who accepted high frequency color Doppler ultrasound,improved intermittent compression strain elastography(IICSE)and nonintermittent compression strain elastography(NCSE)one week ahead of the surgery.By comparing the first three times of IICSE and NCSE,the same elastic result rate was obtained,and the receiver operating characteristic(ROC)curve of IICSE and NCSE elastic score was drawn to identify benign and malignant breast lesions,and the area under the curve(AUC)was calculated,and those with larger AUC area were selected to adjust the classification of BI-RADS.To compare the difference of diagnosis of benign and malignant breast lesions of different BI-RADS classification by high-frequency color ultrasound and high-frequency color ultrasound combined with IICSE,and the difference of the composition ratio of nodules classified by different BI-RADS.Results The consistency rate of elastic results obtained by IICSE was higher than that of NCSE(90.6%vs.34.8%,P<0.05).ROC curve showed that the area under the curve(AUC)of IICSE was greater than that of NCSE(0.865 vs.0.636,P<0.05).Comparing the results before and after high-frequency color ultrasound combined with IICSE,the number of BI-RADS type 3 and type 5 nodules increased significantly,while the number of BI-RADS type 4 nodules decreased(both P<0.05).Conclusion IICSE improves low stability of conventional elastic imaging.At the same time,IICSE reduces the number of patients who need further examination,reducing overuse of medical resources.

关 键 词：乳腺结节 高频彩超检查 改良法间断加压式应变弹性成像 非间断加压式应变弹性成像 

分 类 号：R445[医药卫生—影像医学与核医学]