| 摘要: |
| 摘要 目的 探讨基于剪切波弹性成像（SWE）技术的弹性异质性分析在校正乳腺病灶BI-RADS分类中的价值 方法 对经病理证实的132例患者共135个乳腺病灶，行BI-RADS分类及SWE检测，测得病灶的弹性模量参数，计算SG（刚度梯度）。以病理结果为金标准，绘制ROC曲线，比较校正前及SG校正后BI-RADS分类区分乳腺良恶性病灶的诊断效能。结果 135个乳腺病灶，良性75个，恶性60个。恶性病灶组各弹性模量参数均高于良性病灶组（P<0.001），以SG鉴别诊断乳腺病灶良恶性的ROC曲线下面积（AUC）最高，AUC值为0.925，SG的诊断界点值为120.2kPa时，敏感度为88.3%，特异度为96.0%,准确度为92.6%。以BI-RADS 4b为诊断界点，校正前与SG校正后BI-RADS分类鉴别乳腺病灶良恶性的AUC值为0.914、0.964；敏感度为88.3%、90.0%；特异度为82.7%、92.0%；准确度为85.2%、91.1%。结论 基于SWE技术的弹性异质性定量分析在区分乳腺病灶良恶性中具有重要的临床价值，SG校正后BI-RADS分类较常规超声BI-RADS分类提高了诊断性能，可减少不必要的穿刺活检。 |
| 关键词: 剪切波弹性成像 弹性异质性 乳腺病灶 刚度梯度 |
| DOI： |
| 投稿时间：2020-12-03修订日期：2020-12-16 |
| 基金项目:山西省卫生健康委科研课题 |
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| Diagnostic value of elastic heterogeneity analysis based on SWE technology in correcting BI-RADS category of breast leisions |
| He Hongxia,Chen Wu,Liu Xiaofang,Chen Yaodong,Ren Zhixiang |
| () |
| Abstract: |
| Abstract Objective To explore the application value of elastic heterogeneity analysis based on SWE technology in correcting BI-RADS category of breast leisions. Methods 132 female patients with 135 breast masses were enrolled in this study.All masses were assessed by conventional ultrasound and 2D SWE.The results of BI-RADS classiffication and elastic parameters of leisions were obtained,the Stiffness Gradient(SG) was caculated.Based on the pathological results,the diagnostic efficacy of BI-RADS classiffication and the BI-RADS classiffication adjusted by SG in identifying breast leisions were assessed according to ROC curves.Results In 135 breast masses,There were 75 benign cases and 60 malignant cases.The elastic parameters of malignant leisions were higher than those of benign leisions(P<0.001)，the SG has the largest area under the curve(0.925)compared with other elastic parameters.Using 120.2kPa as a threshold for SG,the diagnostic sensitivity,specificity and accuracy of SG in discriminating the benign and malignant breast leisions were 88.3%,96.0%,92.6%.Taking BI-RADS 4b as the diagnostic cut-off point,the AUC value, sensitivity,specificity and accuracy of BI-RADS category for breast assessment before and after correction by SG were 0.914,0.964;88.3%,90.0%;82.7%,92.0%; 85.2%, 91.1%, respectively.Conclusions The elastic heterogeneity quantitative analysis based on SWE technology is a valuable tool in distinguishing benign and malignant breast lesions.The BI-RADS classification adjusted by SG exhibit better discriminatory ability in differential diagnosis of breast leisions assessment than before,which can assist in reducing the unnecessary biopsies of breast leisions. |
| Key words: Shear wave elastography Elastic Heterogeneity breast leisions Stiffness Gradient |
