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| STE定量分析对乳腺肿瘤良恶性的鉴别诊断价值 |
| Value of quantitative analysis of STE elastography in differential diagnosis of benign and malignant breast tumors |
| 投稿时间：2021-12-20 |
| DOI：10.3969/j.issn.1000-0399.2022.07.004 |
| 中文关键词: 弹性成像 定量 乳腺肿瘤 良恶性 STE |
| 英文关键词: Elastography Quantitative Breast tumor Benign and malignant STE |
| 基金项目:阜阳市科技局自筹经费立项课题(项目编号:FK202081045) |
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| 中文摘要: |
| 目的 探讨声触弹性成像STE定量分析对乳腺良恶性肿瘤的鉴别诊断价值。方法 回顾性分析2020年10月至2021年3月在阜阳市人民医院甲乳外科手术的101例乳腺肿块患者的临床资料,共110个肿块,根据肿块病理结果分为良性组(n=80)和恶性组(n=30),其中良性组72例患者,恶性组29例患者。术前均行BI-RADS分类及STE检查,观察肿块的二维图像信息并测量每个肿块弹性模量值和肿块周缘区域(Shell 2.0 mm)的上述弹性模量值。比较良恶性肿块超声特征、"硬环征"、肿块内部及周缘组织弹性模量值差别。以病理结果为金标准,构建受试者工作特征(ROC)曲线,比较各弹性模量的曲线下面积(AUC),获得诊断效能最佳的弹性模量,比较BI-RADS 分类、弹性模量及二者联合诊断价值。结果 恶性组患者年龄、肿块最大径及肿块"硬环征"发生率均大于良性组,差异均有统计学意义(P均<0.05)。两组肿块在边缘、形态、钙化、腺体后间隙、高回声晕、生长方式及BI-RADS 分类方面比较,差异均有统计学意义(P均<0.05)。良恶性组肿块内部及周围(2.0 mm)弹性模量值比较,恶性组Emax、Esd、E2max、E2mean及E2sd均高于良性组,恶性组Emin与E2min均低于良性组,差异均具有统计学意义(均P<0.05),而两组肿块Emean比较,差异无统计学意义(P>0.05)。BI-RADS 分类及各组弹性模量(Emean、Emax、Esd )的ROC结果显示,BI-RADS 分类与E2max(Shell 2.0 mm)AUC较大,分别0.943、0.841,最佳临界值分别4a-4b、87.10 kPa,敏感度分别90.00%、93.30%,特异度分别85.00%、58.70%,两者联合诊断AUC 为0.982,敏感度96.70%,特异度92.50%。结论 STE弹性成像定量指标对乳腺良恶性肿瘤鉴别具有一定的应用价值,E2max诊断效能最佳,BI-RADS 分类与E2max联合应用可明显提高诊断效能。 |
| 英文摘要: |
| Objective To explore the value of quantitative analysis of Sound Touch Elastography(STE)in the differential diagnosis of benign and malignant breast tumors. Methods The clinical data of 101 patients with breast masses who underwent surgery in Fuyang People’s Hospital from October 2020 to March 2021 were retrospectively analyzed. According to the pathological results of the masses,a total of 110 masses were divided into benign group (n=80) and malignant group (n=30);there were 72 patients in the benign group and 29 patients in the malignant group.Preoperative BI-RADS classification and STE examination were used to observe the two-dimensional image information, the elastic modulus values of each mass were measured,and the above elastic modulus values of the surrounding area of the mass (shell 2.0 mm)were assessed as well.The difference in ultrasonic characteristics,"hard ring sign",and the elastic modulus of each mass and its peripheral tissue were compared between benign and malignant masses.Taking the pathological results as the gold standard,ROC curve was constructed to compare the area under the curve (AUC) of each elastic modulus and obtain the best diagnostic efficiency of the elastic modulus. Lastly,the diagnostic value of BI-RADS classification,the above elastic modulus and their combination were compared. Results The age, the maximum diameter and the incidence of "hard ring sign" of the mass of malignant group were significantly higher than those of benign group, and the difference was statistically significant(P<0.05).There were also significant differences in edge, morphology, calcification, posterior glandular space, hyperechoic halo, growth mode and BI-RADS classification between benign and malignant tumors (all P<0.05).The values of Emax, Esd, E2max, E2meen and E2sd in malignant group were higher than those in benign group, the Emin and E2min in malignant group were lower than those in benign group (all P<0.05), andthe difference was statistically significant,but there was no significant difference between the two groups in Emean (P>0.05). BI-RADS classification and elastic modulus (Emean, Emax, Esd) ROC of each group showed that AUC of E2max and BI-RADS classification larger,which was 0.943 and 0.841 respectively,the optimum critical value was 4a-4b,87.10 kPa respectively,the sensitivity was 90.00%,93.30% respectively,and specificity was 85.00% and 58.70% respectively.ROC of the combination showed AUC of 0.982,the sensitivity 96.70%,and the specificity 92.50%.Conclusions The quantitative index of STE has certain application value in the differentiation of benign and malignant breast tumors. The combined application of BI-RADS classification and E2max significantly improves the diagnostic efficiency. |
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