弹性定量参数在触诊阴性乳腺实性肿块中的应用价值
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上海市第一人民医院宝山分院

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上海市宝山区科技发展基金项目(12-E-7)


Application of quantitative ultrasound elastic parameters in NPBL
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    摘要:

    目的 探讨弹性定量参数在临床触诊阴性乳腺病(non-palpablebreast lesions,NPBL)中的诊断价值。方法 选取2013年1月-2015年6月在我院行高频超声并经手术病理证实的NPBL患者。依照手术后病理结果分为良性病灶组(A组,n=110),恶性病灶组(B组,n=40)。分别比较并分析两组弹性应变率(SR)比值、直径变化率、面积比及二维超声检查。应用受试者操作特性曲线(ROC)曲线分析SR比值、直径变化率、面积比、二维超声及三种弹性定量参数联合诊断乳腺癌的ROC曲线下面积(AUC)、最佳界值、敏感度和特异度。结果B组SR水平(6.04±2.53)显著高于A组水平(2.86±1.51),差异有统计学意义(t=5.031;p=0.000)。根据两组SR水平制作ROC曲线,AUC为0.844,以5.22作为最佳界值,诊断乳腺癌的敏感度为57.5%,特异度为96.4%。B组病灶的直径变化率(0.28±0.12)显著高于A组(0.17±0.09),同时面积比(1.96±0.28)亦显著高于A组(1.12±0.33)(p值均<0.05)。通过SR、直径变化率、面积比水平联合诊断乳腺癌,敏感度为77.5%,特异度为94.5%,AUC为0.937,高于单项指标。结论 通过三种弹性定量参数联合诊断能够提高对乳腺癌的诊断能力。

    Abstract:

    Objective To investigate the value of quantitative ultrasound elastic parameters in NPBL. Methods Patients with NPBL who met the inclusion criteria in our hospital between January 2013 and June 2015 were recruited. They were divided into benign lesions group (Group A, n=110) , malignant lesions group (Group B, n=40) according to surgical-pathological results. Patients were examined with mammography,two dimensional ultrasonography and elastography.The SR, the rate change in diameter, the area ratio between Group A and B were compared and analyzed. ROC curves were drawn to evaluate the AUC, diagnostic threshold, sensitivity and specificity of benign lesions and malignant lesions. Results Compared to Group A(2.86±1.51), Group B(6.04±2.53) showed significantly higher levels of SR (t=5.031;p=0.000).The threshold of ROC Curve in diagnosing breast cancer was 5.22 with the sensitivity of 57.5%,the specificity of 96.4% and AUC of 0.844. Compared with the rate change in diameter (0.17±0.09)and the area ratio(1.12±0.33)in Group A, patients in Group B have a significantly higher level the rate change in diameter(0.28±0.12) and the area ratio(1.96±0.28)(All P<0.05). The combined indicator of SR, rate change in diameter and area ratio showed a better ability in diagnosis of breast lesion than the individual indicators (sensitivity 77.5%, specificity 94.5%, AUC 0.937). Conclusion Combined Quantitative ultrasound elastic parameters can effectively identify benign and malignant breast lesions.

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姚丽华.弹性定量参数在触诊阴性乳腺实性肿块中的应用价值[J].临床超声医学杂志,2017,19(10):

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  • 收稿日期:2016-05-10
  • 最后修改日期:2016-07-24
  • 录用日期:2016-07-25
  • 在线发布日期: 2017-10-26
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