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弹性应变率比值联合乳腺超声影像报告和数据系统诊断乳腺结节的应用价值
Value of Elastography Strain Ratio Combined with Breast Ultrasound Imaging Reporting and Data System in the Diagnosis of Breast Nodules

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刘健 1   武敬平 1   王宁 2   李广涵 1   王秀红 3   王瑛 1   郑敏 1   张波 1 *  
文摘 目的探讨弹性应变率比值(SR)与乳腺超声影像报告和数据系统(BI-RADS-US)联合诊断乳腺结节的应用价值。方法回顾性分析经病理确诊的471例乳腺结节,术前行常规超声及应变弹性成像检查,应用SR联合BI-RADS-US对乳腺结节分类进行分级调整,以病理结果为金标准,通过受试者工作特征(ROC)曲线下面积评估联合法与BI-RADS-US单独诊断乳腺结节的效能,比较两者敏感度、特异度及准确性。结果471例乳腺结节中,良性180例,恶性291例,联合法诊断乳腺癌的ROC曲线下面积明显高于BI-RADS-US (0.798比0.730; Z = 2.583,P = 0.010) 。SR法、BI-RADS-US及联合法诊断乳腺癌的敏感度分别为86.6%、99.0%、96.6%,特异度分别为67.2%、47.2%、63.3%,准确性分别为79.2%、 79.2%、83.9%。联合法较BI-RADS-US单独诊断乳腺癌特异度从47.2%提高到63.3% (χ~2 = 14.25,P < 0.001),将57.5% (42/73) BI-RADS 4A类中的良性结节降为3类。结论SR联合BI-RADS-US可明显提高乳腺癌的诊断效能,提高诊断特异度,避免不必要的穿刺活检。
其他语种文摘 Objective To explore the value of elastography strain ratio (SR) combined with breast ultrasound imaging reporting and data system (BI-RADS-US) in the differential diagnosis of breast nodules.Methods A total of 471 breast nodules (from 471 patients) were reclassified by SR combined with BI-RADS-US. With the pathology results as gold standard,the area under the receiver operating characteristic (ROC) curve (AUC) was employed to evaluate the diagnostic performance,and the sensitivity,specificity,and accuracy were compared between the combined method and BI-RADS-US. Results Among the 471 breast nodules,180 nodules were benign and 291 were malignant. The AUC of the combined method was statistically significantly higher than that of BI-RADS-US (0.798 vs. 0.730; Z = 2.583,P = 0.010). SR,BI-RADS-US,and the combined method for diagnosing breast nodules had the sensitivity of 86.6%,99.0%,and 96.6%,the specificity of 67.2%, 47.2%,and 63.3%,and the accuracy of 79.2%,79.2%,and 83.9%,respectively. The combined method increased the specificity from 47.2% (BI-RADS-US) to 63.3% (χ~2 = 14.25,P < 0.001),and downgraded 57.5% (42/73) benign nodules of BI-RADS category 4A to category 3. Conclusions SR combined with BI-RADSUS can improve the diagnostic performance for breast nodules. Especially,it can improve the specificity,avoiding unnecessary biopsy of breast nodules.
来源 中国医学科学院学报 ,2021,43(1):63-68 【核心库】
DOI 10.3881/j.issn.1000-503x.12839
关键词 超声 ; 弹性成像 ; 应变率比值 ; 乳腺结节
地址

1. 中日友好医院超声医学科, 北京, 100029  

2. 中日友好医院普通外科二部, 北京, 100029  

3. 中日友好医院病理科, 北京, 100029

语种 中文
文献类型 研究性论文
ISSN 1000-503X
学科 临床医学;肿瘤学
基金 国家卫生和计划生育委员会中日友好医院项目 ;  中日友好医院引进人才项目
文献收藏号 CSCD:6932401

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引证文献 3

1 郭凌娟 剪切波弹性成像在乳腺结节诊断和引导穿刺活检中的应用价值 中国超声医学杂志,2022,38(8):851-854
CSCD被引 2

2 吴静 二维超声特征联合超声弹性应变率比值在乳腺癌中的诊断价值及与病理预后指标的相关性分析 中国医学物理学杂志,2024,41(2):175-180
CSCD被引 0 次

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