|
|
|
| The Value of SWE Combined with BI-RADS Grading in the Differential Diagnosis of Breast Masses and the Relationship with Pathological Features |
| YUAN Changhe, WEI Jie |
| The Second People's Hospital of Hefei, Anhui Hefei 230011, China |
|
|
|
|
Abstract Objective: To explore the value of shear wave elastography (SWE) combined with breast imaging reporting and data system (BI-RADS) grading in the differential diagnosis of breast masses and its relationship with pathological features. Methods: 96 patients with breast masses were examined by conventional breast ultrasonography and SWE, and the BI-RADS grading and modified SWE scoring were performed. With the diagnostic results of pathology as the golden standard, the diagnostic efficiency of BI-RADS grading and its combination with SWE in the differential diagnosis of breast masses was evaluated by the area under receiver operating characteristic (ROC) curve (AUC). The strain ratio of ultrasonic elastography of normal tissues and mass tissues was measured by SWE, and its relationship with pathological features was analyzed. Results: In the 96 patients, there were benign and malignant masses in 67 cases and 29 cases respectively diagnosed by pathology. There were statistically significant differences of BI-RADS grade and SWE score between benign and malignant masses (P < 0.05). The ROC curve showed that the AUC of BI-RADS grading and SWE combined with BI-RADS grading in the differential diagnosis of breast masses were 0.83 and 0.91 respectively. The specificity, positive predictive value, negative predictive value of SWE combined with BI-RADS grading in the diagnosis of benign and malignant breast masses were significantly higher than those of BI-RADS grading alone. In the 96 patients, the strain ratio of ultrasonic elastography was lower than 3.08 in 68 cases and more than 3.08 in 28 cases, with statistically significant differences between the two in the shape of masses, boundary, aspect ratio, echo, calcification, blood flow and other pathological features (P < 0.05). Logistic regression and multivariate analysis showed that shape of masses, boundary, aspect ratio, echo, calcification and blood flow were independent influencing factors of elasticity strain ratio larger than 3.08 (P < 0.05). Conclusion: SWE combined with BI-RADS grading can fully display the histological and pathological features of breast masses, which is helpful for the differential diagnosis of benign and malignant breast masses.
|
|
|
|
|
|
[1] Tangeruda,Potapenko I,Skjerven H K,et al.Radiologic evaluation of lumps in the male breast.[J].Acta Radiologica,2015,57(7):481~484.
[2] 傅晓红,沈燕,刘淼,等.声触诊组织成像和定量技术鉴别并优化BI-RADS 4类乳腺肿块的价值[J].中国临床医学,2017,24(2):214~218.
[3] 尤其琴,吴蓉.声脉冲辐射力弹性成像对BI-RADS 4类乳腺肿块的诊断价值[J].解放军预防医学杂志,2016,34(6):890~893.
[4] 彭晓静,胡彧,巩海燕,等.实时剪切波弹性成像联合超声造影优化乳腺病变BI-RADS分类的价值[J].中国临床医学影像杂志,2017,28(6):400~404.
[5] 彭晓静,巩海燕,许迪,等.实时剪切波弹性成像和超声造影对BI-RADS 4类乳腺病变诊断效能的对比研究[J].临床超声医学杂志,2017,19(8):510~513.
[6] 胡彧,彭晓静,李奥,等.超声剪切波弹性成像结合应变式弹性成像诊断乳腺病灶的多因素Logistic回归分析[J].现代肿瘤医学,2017,25(19):3142~3146.
[7] 胡彦,徐超丽,杨斌.超声弹性成像定量参数对乳腺实性肿块的鉴别诊断分析[J].医学研究生学报,2016,29(8):836~840.
[8] 王小颖,杨晓青,冯钰瑾.BI-RADS分级结合弹性比值法对乳腺良恶性肿块的诊断价值[J].河北医药,2017,39(20):3127~3129.
[9] Kawashima H,Ariizumi T,Saijo Y,et al.Chromosomal rearrangements in myoepithelial carcinoma of the breast that presented as metachronic double cancer with invasive ductal carcinoma in the ipsilateral breast[J].Cancer Genetics,2016,209(11):501.
[10] 丛瑞,李晶.感兴趣区大小对剪切波弹性成像诊断乳腺肿块的影响[J].中国介入影像与治疗学,2017,14(9):534~538.
[11] 周文娟,陈超,王林,等.剪切波超声弹性成像在鉴别乳腺肿块良恶性中的应用价值[J].中国临床研究,2016,29(8):1112~1113.
[12] 巫朝君,杨伟雄,卢超政,等.剪切波超声弹性成像在乳腺疾病中的应用[J].中国医药导报,2015,12(1):90~93.
[13] 赵青,牟洋,赵献萍,等.超声弹性成像与钼靶对乳腺肿块BI-RADS分类诊断价值[J].中华实用诊断与治疗杂志,2017,31(6):589~591.
[14] 张威,王博,李晶,等.剪切波弹性成像定性技术鉴别诊断乳腺良恶性肿块[J].中国医学影像技术,2016,32(7):1060~1064. |
|
|
|
2018, Vol. 24 
