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| 平面波超敏感血流显像和实时剪切波弹性成像对乳腺癌诊断的价值分析 |
| 罗季平,李渝,陈亚萍,周桃,唐博,黄多,岳文胜 |
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| (川北医学院附属医院超声科,川北医学院附属医院院士工作站,川北医学院附属医院超声研究室,医学影像四川省重点实验室,超声医学工程南充市重点实验室 宜宾市第六人民医院功能科) |
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| 摘要: |
| 目的 探究平面波超敏感血流显像（AP）、实时剪切波弹性成像（SWE）及二者联合诊断乳腺癌的应用价值。方法 纳入101个常规超声BI-RADS分类3~5类的乳腺结节，对结节进行AP显像，根据血流特征进行半定量血流分级与微血管构筑分型。切换至SWE模式，获取稳定的弹性图像后分析得到SWE色彩分型并进行定量分析，获得杨氏模量值 Emax、Emean。以病理结果为金标准，绘制相关参数ROC曲线，分析并比较AP、SWE单独及联合应用诊断乳腺癌的效能差异。结果 乳腺恶性病灶的 Emax、 Emean、 SWE分型、 AP分型、AP分级均显著高于良性病灶（P均<0.001）；AP半定量血流分级良性肿瘤以乏血供为主，恶性肿瘤以富血供为主；微血管构筑分型中良性肿瘤以为无血管型、线型、树枝型血流为主，恶性肿瘤以残根型和蟹足型为主；AP微血管构筑分型法优于血流半定量分级法（P<0.05）；SWE定量分析Emax的诊断效能高于Emean（P<0.05）；SWE色彩分型良性肿瘤以均匀蓝色或大部分显示蓝色为主，恶性肿瘤以边缘局限性彩色改变或内部及周边不均匀彩色改变为主；AP分型、Emax及二者联合诊断乳腺癌的AUC分别为0.898、0.918、0.945。结论 AP和SWE对乳腺肿瘤均具有较好的鉴别诊断能力，二者联合应用能显著提升乳腺癌的诊断效能。 |
| 关键词: 平面波超敏感血流显像 剪切波弹性成像 超声检查 乳腺癌 诊断效能 |
| DOI： |
| 投稿时间：2022-04-18修订日期：2022-05-28 |
| 基金项目: |
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| Analysis of the value of angio planewave ultrasensitive imaging and real-time shear wave elastography for the diagnosis of breast cancer |
| luojiping,liyu,chenyaping,zhoutao,tangbo,huangduo,yuewensheng |
| (The Affiliated Hospital of North Sichuan Medical College) |
| Abstract: |
| Abstract：Objective Investigating the value of angio planewave ultrasensitive imaging (AP), real-time shear wave elastography (SWE) and their combined application in the diagnosis of breast cancer. Methods 101 breast nodes with conventional ultrasound BI-RADS classification 3-5 were included, and AP imaging was performed on the nodes, and semi-quantitative blood flow grading and microvascular configuration typing were performed according to blood flow characteristics. Switch to SWE mode, obtain stable elastic images and then analyze to get SWE color typing and perform quantitative analysis to obtain Young's modulus values Emax, Emean. Using pathological findings as the gold standard, ROC curves of relevant parameters were plotted to analyze and compare the difference in efficacy of AP and SWE alone and in combination for the diagnosis of breast cancer. Results Emax, Emean, SWE typing, AP typing and AP grading were significantly higher in malignant breast lesions than in benign lesions (all P < 0.001). In the AP semi-quantitative blood flow grading, benign tumors are dominated by a lack of blood supply and malignant tumors are dominated by a rich blood supply. In microvascular configuration typing benign tumors are thought to be predominantly avascular, linear, and dendritic blood flow, while malignant tumors are predominantly stump and crab foot type. AP microvascular configuration typing method was superior to the semi-quantitative grading method of blood flow (P<0.05). The diagnostic efficacy of SWE quantitative analysis Emax was higher than that of Emean (P<0.05). SWE color typing is predominantly uniform blue or mostly blue for benign tumors, and restricted color changes at the edges or uneven color changes within and around malignant tumors. In the SWE color typing, benign tumors show predominantly uniform blue color or mostly blue color, and malignant tumors show predominantly restricted color changes at the edges or uneven color changes inside. The AUCs of AP typing, Emax and the combination of the two in diagnosing breast cancer were 0.898, 0.918 and 0.945. Conclusion Both AP and SWE have good differential diagnostic ability for breast tumors, and their combined application can significantly improve the diagnostic efficacy of breast cancer. |
| Key words: Angio planewave ultrasensitive imaging Shear wave elastography Ultrasonography Breast cancer Diagnostic efficacy |
