常规超声联合超声弹性成像检查对乳腺黏液癌的诊断价值  

The diagnostic value of conventional ultrasound combined with ultrasonic elastography in mucinous breast carcinoma

作　　者：宋佳佳 张一丹 孔文韬[1] SONG Jiajia;ZHANG Yidan;KONG Wentao(Department of Ultrasound Diagnosis,Nanjing Drum Tower Hospital,The Affiliated Hospital of Nanjing University Medical School,Nanjing 210000,Jiangsu Province,China)

机构地区：[1]南京大学医学院附属鼓楼医院超声诊断科,江苏南京210000

出　　处：《肿瘤影像学》2024年第4期418-424,共7页Oncoradiology

摘　　要：目的:分析乳腺黏液癌的临床特征及超声表现,探讨常规超声联合弹性成像技术对乳腺黏液癌的诊断价值。方法:回顾并分析2014年—2022年南京大学医学院附属鼓楼医院经病理学检查证实为乳腺黏液癌的患者63例(共63个肿块),并随机选取同期经病理学检查证实为乳腺纤维腺瘤的50例患者(共50个肿块)为对照组。113个肿块均行乳腺常规超声及应变式弹性成像检查,观察记录肿块大小、形状、边界、弹性评分等,并根据乳腺影像报告和数据系统(Breast Imaging Reporting and Data System,BI-RADS)分类标准分类。其中78例肿块应用剪切波弹性成像技术定量分析。比较两组患者的临床与超声特征差异。结果:常规超声联合应变式弹性成像检查的灵敏度(85.71%vs 65.07%)、特异度(94.00%vs 88.00%)、阳性预测值(94.73%vs 87.23%)、阴性预测值(83.93%vs 66.67%)及准确度(89.38%vs 75.22%)均高于常规超声。常规超声联合应变式弹性成像检查的诊断一致性Kappa指数高于常规超声(0.787 vs 0.514)。剪切波弹性成像技术检查提示两组肿块的剪切波速度(shear wave velocity,SWV)最大值、最小值、平均值分别为(7.26±2.41)m/s vs(3.77±1.79)m/s、(3.16±1.09)m/s vs(2.23±0.79)m/s、(4.82±1.39)m/s vs(2.91±1.02)m/s,差异有统计学意义(P<0.05)。结论:常规超声联合弹性成像技术在乳腺黏液癌诊断中具有一定临床价值。Objective:To analyze the clinical characteristics and ultrasonic manifestations of breast mucinous carcinoma and explore the diagnostic value of conventional ultrasound combined with ultrasonic elastography in breast mucinous carcinoma.Methods:The retrospective study analyzed 63 patients(63 masses)with mucinous breast carcinoma confirmed by pathological examination in Nanjing Drum Tower Hospital,The Affiliated Hospital of Nanjing University Medical School from 2014 to 2022.50 patients(50 masses)with fibroadenoma confirmed by pathological examination during the same period were randomly selected as the control group.All 113 masses underwent conventional breast ultrasonography and strain elastography to observe and record the mass size,shape,boundary,elasticity score,etc.The masses were also classified according to the Breast Imaging Reporting and Data System(BI-RADS)classification criteria.Among them,78 masses were quantitatively analyzed using shear wave elastography.The clinical and ultrasonic characteristics of the two groups were compared.Results:The sensitivity(85.71%vs 65.07%),specificity(94.00%vs 88.00%),positive predictive value(94.73%vs 87.23%),negative predictive value(83.93%vs 66.67%)and accuracy(89.38%vs 75.22%)of conventional ultrasound combined with strain elastography were higher than those of conventional ultrasound alone.The diagnostic consistency Kappa index of conventional ultrasonography combined with strain elastography was higher than that of conventional ultrasound(0.787 vs 0.514).Shear wave elastography showed that the maximum,minimum,and average shear wave velocities of the two groups were(7.26±2.41)m/s vs(3.77±1.79)m/s,(3.16±1.09)m/s vs(2.23±0.79)m/s,(4.82±1.39)m/s vs(2.91±1.02)m/s,respectively,with statistically significant differences(P<0.05).Conclusion:Conventional ultrasound combined with elastography has certain clinical value in the diagnosis of mucinous breast carcinoma.

关 键 词：乳腺黏液癌 超声 超声弹性成像 乳腺影像报告和数据系统 

分 类 号：R737.9[医药卫生—肿瘤] R445.1[医药卫生—临床医学]