| 摘要: |
| 目的 探讨剪切波弹性成像(SWE)技术联合常规超声对小乳腺癌(最大经≦2cm)鉴别诊断价值。方法：搜集171例,共177个小乳腺病变(最大径≦2cm),术前均行BI-RADS 分类及剪切波弹性检测,获得所有乳腺病变的剪切波定量参数,应用受试者工作特征(ROC)曲线确定Emax的诊断临界值,以病理为金标准,评价SWE联合常规超声的诊断效能并分析Emax对BI-RADS 4a类小乳腺病变良恶性的诊断价值。结果：177例≦2cm乳腺实性病变中,组织病理学检查为良性病变155个(87.57%),恶性病变22个(12.94%),恶性病变组的SWE定量参数均大于良性病变组,差异有统计学意义(P<0.05)；Emax联合常规超声对评价小乳腺病变良恶性的ROC曲线面积小于常规超声；以Emax 87.5Kpa作为诊断临界值,BI-RADS 4a类病变中71例(75.53%)降为3类,其中包含5例恶性病变,BI-RADS 3类病变的假阴性率由0%上升到3.8%(P<0.05)。结论：Emax联合BI-RADS分类可以显著提高小乳腺癌诊断的特异度和准确度,减少在临床诊疗中4a类病变不必要的穿刺率和手术率,但是对于小于2cm的乳腺可疑恶性病变时,我们应该适当降低诊断临界值的的保守策略,从而降低假阴性率病例的出现。 |
| 关键词: 乳腺 超声 剪切波弹性成像 诊断 |
| DOI： |
| 投稿时间：2020-04-05修订日期：2020-04-14 |
| 基金项目: |
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| The diagnostic value of shear wave elastography combined with conventional ultrasound in small breast cancer |
| wangxilong |
| (The First Affiliated Hospital of Anhui Medical University) |
| Abstract: |
| Objective The aim of this study is to evaluate the diagnostic value of shear wave elastography (SWE) added to conventional ultrasound (US) in the diagnosis of small (2 cm) breast cancer.Methods Among patients who underwent SWE and US before biopsy or surgical operation , 171 patients with 177 small (≦2 cm) breast lesions were enrolled in this study.Diagnostic performances of each quantitative SWE parameters were calculated by receiver operating characteristic (ROC) curves. Performances of conventional US and US combined to SWE was also compared.And the diagnostic value of Emax in small Breast Imaging Reporting and Data System (BI-RADS) category 4a lesions.Histologic diagnosis was used as a reference standard.Results Of the 177 lesions, 22 lesions (12.4%) were malignant and 155(87.6%) were benign.SAll average quantitative elastography values were signi?cantly higher in malignant comparing with benign lesions(P<0.05).Az value of combined Emax with US was signi?cantly lower than that of conventional US alone (P<0.05).SBy using cutoff of Emax 87.5Kpa for downgrading BI-RADS category 4a lesions to category 3, 76/94 category 4a lesions (80.9%) were downgraded.SAfter downgrading, 5 cancers were missed and the malignancy rate of category 3 lesions increased from 0% (0/55) to 3.8% (5/133) (P <0.05). |
| Key words: breast ultrasound shear wave elastography diagnosis |
