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目的分析实时剪切波弹性成像技术(SWE)各定量参数及弹性图像特征在鉴别乳腺良恶性实性病变中的价值,筛选出最佳的诊断参数。方法对155例女性患者共166个乳腺病变行常规超声及SWE检查,定量测量病灶弹性模量值,包括最大弹性值Emax、平均弹性值Emea、弹性标准差Esd及病灶/脂肪弹性比Eratio;定性评估病灶弹性图像特征,并将其分为四种类型。结果 SWE弹性图像类型及定量参数Emax、Emea、Esd及Eratio在乳腺良恶性病灶间均有显著性统计学差异(P<0.0001)。通过绘制ROC曲线,Emax的AUC在所有定量参数中最大(0.920),界值为49.27kPa;SWE弹性图像类型的AUC为0.873,界值为3型。将定量参数Emax与弹性图像特征联合应用,其诊断的灵敏度、特异度及准确率分别为(89.1%、91.7%、91.0%)。结论 SWE定量及定性参数均可用于鉴别乳腺良恶性实性病变,定量参数Emax的诊断效能最大,与弹性图像特征联合应用将进一步提高诊断的准确率。
Objective To analyze the value of quantitative parameters and elastic image features of real-time shear wave elastography (SWE) in differentiating benign and malignant breast lesions and to screen out the best diagnostic parameters. Methods A total of 166 breast lesions in 155 female patients underwent routine ultrasound and SWE. Quantitative measurement of lesion modulus of elasticity, including Emax, Emea, Esd and Eratio, Lesions elastic image characteristics were evaluated and divided into four types. Results The types and quantitative parameters of Elastic elastography EME, Emea, Esd and Eratio were significantly different between benign and malignant breast lesions (P <0.0001). By plotting the ROC curve, the AUC of Emax was the largest (0.920) among all the quantitative parameters, with a cutoff of 49.27 kPa; the AUC of the SWE elastic image type was 0.873 and the cutoff was type 3. The sensitivity, specificity and accuracy of the quantitative parameters Emax and elastic image characteristics were 89.1%, 91.7% and 91.0%, respectively. Conclusion The quantitative and qualitative parameters of SWE can be used to identify benign and malignant breast lesions. The diagnostic value of quantitative parameter Emax is the largest. Combined with the characteristics of elastic images will further improve the diagnostic accuracy.