Thomas Anke, Kümmel Sherko, Fritzsche Florian, Warm Mathias, Ebert Bernd, Hamm Bernd, Fischer Thomas
Department of Obstetrics and Gynecology, Chariteplatz, Charité - Universitätsmedizin, Berlin 10117, Germany.
Acad Radiol. 2006 Dec;13(12):1496-504. doi: 10.1016/j.acra.2006.08.012.
The goal of the present study was to compare the sensitivity and specificity of elastography with that of B-mode ultrasound (US) and mammography.
A total of 300 patients with histologically confirmed breast lesions (168 benign, 132 malignant) were included. Evaluation was by means of the three-dimensional finite-element method. The data are color-coded and superimposed on the B-mode US scan. The images were evaluated by two independent readers. The results were compared with mammography, histology, and the data obtained by previous US investigations. Sensitivities and specificities were calculated.
Sensitivity and specificity in the differentiation of benign and malignant lesions were 87% and 85%, respectively, for mammography and 94% and 83% for B-mode US. The two examiners were in very good agreement in their evaluation of the elastograms (kappa: 0.86). Elastography had a sensitivity of 82% and a specificity of 87%. Elastography was superior to B-mode US in diagnosing Breast Imaging Reporting and Data System (BI-RADS) 3 lesions (92% vs. 82% specificity) and in lipomatous involution (80% vs. 69% specificity).
Elastography in breast lesions showed a higher specificity and a lower sensitivity in comparison with B-mode sonography. Elastography may be beneficial in BI-RADS 3 lesions and in lipomatous involution.
本研究的目的是比较弹性成像与B型超声（US）及乳腺X线摄影的敏感性和特异性。
共纳入300例经组织学证实的乳腺病变患者（168例良性，132例恶性）。采用三维有限元方法进行评估。数据以彩色编码并叠加在B型超声扫描图像上。由两名独立的阅片者对图像进行评估。将结果与乳腺X线摄影、组织学检查以及先前超声检查获得的数据进行比较。计算敏感性和特异性。
乳腺X线摄影在鉴别良性和恶性病变中的敏感性和特异性分别为87%和85%，B型超声分别为94%和83%。两名检查者对弹性成像图的评估一致性非常好（kappa值：0.86）。弹性成像的敏感性为82%，特异性为87%。在诊断乳腺影像报告和数据系统（BI-RADS）3类病变（特异性为92%对82%）和脂肪退化（特异性为80%对69%）方面，弹性成像优于B型超声。
与B型超声相比，乳腺病变弹性成像显示出更高的特异性和更低的敏感性。弹性成像在BI-RADS 3类病变和脂肪退化方面可能有益。
