Scaperrotta Gianfranco, Ferranti Claudio, Costa Claudia, Mariani Luigi, Marchesini Monica, Suman Laura, Folini Cristina, Bergonzi Silvana
Department of Breast Imaging, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy.
Eur Radiol. 2008 Nov;18(11):2381-9. doi: 10.1007/s00330-008-1032-8. Epub 2008 Jun 4.
The purpose of this study was to evaluate the diagnostic utility of sonoelastography in differentiating benign from malignant non-palpable breast lesions. A total of 293 BI-RADS 3-5 (Breast Imaging Reporting And Data System) impalpable breast lesions in 278 women was evaluated with B-mode ultrasound (US) and subsequently with sonoelastography (SE) before performing US-guided biopsy. Among the 293 lesions (size up to 2 cm), 110 (37.5%) were histologically malignant and 183 (62.5%) benign. Lesions that were malignant or showed atypical ductal hyperplasia were referred for surgical excision, as well as 32 benign lesions showing discordance between US/SE results and histology. All other benign lesions had US follow-up at 6/12 months, showing stability. Overall performance of SE was lower than US, with sensitivity and specificity of 80% and 80.9%, respectively, for SE as compared with 95.4% and 87.4% for US. Statistical analysis showed no improvement in the joint use of SE and US over the use of US alone, whose performance, however, was very high in our study. SE is a simple, fast and non-invasive diagnostic method that may be a useful aid to US for less experienced radiologists in the assessment of solid non-palpable breast lesions, especially BI-RADS 3, where specificity was higher (88.7%).
本研究的目的是评估超声弹性成像在鉴别不可触及的乳腺良性和恶性病变中的诊断效用。在278名女性中，共有293个BI-RADS 3-5级（乳腺影像报告和数据系统）不可触及的乳腺病变在进行超声引导活检前，先用B型超声（US）进行评估，随后用超声弹性成像（SE）进行评估。在这293个病变（大小达2厘米）中，110个（37.5%）经组织学检查为恶性，183个（62.5%）为良性。恶性病变或显示非典型导管增生的病变以及32个超声/超声弹性成像结果与组织学结果不一致的良性病变均被转诊进行手术切除。所有其他良性病变在6/12个月时进行超声随访，结果显示稳定。超声弹性成像的总体表现低于超声，其敏感性和特异性分别为80%和80.9%，而超声的敏感性和特异性分别为95.4%和87.4%。统计分析表明，联合使用超声弹性成像和超声与单独使用超声相比并无改善，不过在我们的研究中超声的表现非常高。超声弹性成像是一种简单、快速且无创的诊断方法，对于经验较少的放射科医生在评估不可触及的实性乳腺病变，尤其是特异性较高（88.7%）的BI-RADS 3级病变时，可能是超声的一种有用辅助手段。
