Zhi Hui, Ou Bing, Luo Bao-Ming, Feng Xia, Wen Yan-Ling, Yang Hai-Yun
Department of Ultrasound, Second Affiliated Hospital, Sun Yat-Sen University, Guangzhou China.
J Ultrasound Med. 2007 Jun;26(6):807-15. doi: 10.7863/jum.2007.26.6.807.
The purpose of this study was to evaluate the value of ultrasound elastography (UE) in differentiating benign versus malignant lesions in the breast and compare it with conventional sonography and mammography.
From September 2004 to May 2005, 296 solid lesions from 232 consecutive patients were diagnosed as benign or malignant by mammography and sonography and further analyzed with UE. The diagnostic results were compared with histopathologic findings. The sensitivity, specificity, accuracy, positive and negative predictive values, and false-positive and -negative rates were calculated for each modality and the combination of UE and sonography.
Of 296 lesions, 87 were histologically malignant, and 209 were benign. Ultrasound elastography was the most specific (95.7%) and had the lowest false-positive rate (4.3%) of the 3 modalities. The accuracy (88.2%) and positive predictive value (87.1%) of UE were higher than those of sonography (72.6% and 52.5%, respectively). The sensitivity values, negative predictive values, and false negative rates of the 3 modalities had no differences. A combination of UE and sonography had the best sensitivity (89.7%) and accuracy (93.9%) and the lowest false-negative rate (9.2%). The specificity (95.7%) and positive predictive value (89.7%) of the combination were better, and the false-positive rate (4.3%) of the combination was lower than those of mammography and sonography.
In a clinical trial with Chinese women, UE was superior to sonography and equal or superior to mammography in differentiating benign and malignant lesions in the breast. A combination of UE and sonography had the best results in detecting cancer and potentially could reduce unnecessary biopsy. Ultrasound elastography is a promising technique for evaluating breast lesions.
本研究旨在评估超声弹性成像（UE）在鉴别乳腺良恶性病变中的价值，并将其与传统超声及乳腺X线摄影进行比较。
2004年9月至2005年5月，对232例连续患者的296个实性病变进行乳腺X线摄影和超声检查，诊断为良性或恶性，并进一步行UE检查。将诊断结果与组织病理学结果进行比较。计算每种检查方法以及UE与超声联合检查的敏感性、特异性、准确性、阳性和阴性预测值，以及假阳性和假阴性率。
296个病变中，组织学检查为恶性的有87个，良性的有209个。超声弹性成像在三种检查方法中特异性最高（95.7%），假阳性率最低（4.3%）。UE的准确性（88.2%）和阳性预测值（87.1%）高于超声（分别为72.6%和52.5%）。三种检查方法的敏感性、阴性预测值和假阴性率无差异。UE与超声联合检查的敏感性最佳（89.7%）、准确性最佳（93.9%），假阴性率最低（9.2%）。联合检查的特异性（95.7%）和阳性预测值（89.7%）较好，假阳性率（4.3%）低于乳腺X线摄影和超声。
在一项针对中国女性的临床试验中，UE在鉴别乳腺良恶性病变方面优于超声，与乳腺X线摄影相当或更优。UE与超声联合检查在检测癌症方面效果最佳，可能减少不必要的活检。超声弹性成像是一种很有前景的乳腺病变评估技术。
