Vanhoutte A, Fellah L, Galant C, d'Hoore W, Berlière M, Leconte I
Département d'lmagerie Médicale, Université Catholique de Louvain, Cliniques Universitaires St Luc, Avenue Hippocrate 10, B-1200 Brussels, Belgium.
JBR-BTR. 2008 Sep-Oct;91(5):187-94.
We evaluate the performances of sonoelastography in the characterization of breast nodules with histologic correlation. Elastosonography was performed immediately after mode B sonography in 59 patients (65 nodules) by two radiologists, independently. All sequences of elastosonography were recorded. An intra and inter -observers correlation was calculated. Each nodule was classified with BI-RADS lexicon and with Ueno elastography classification. The scores 1-3 were considered as benign and 4-5 as malignant. A cytologic/histologic diagnosis was available for all nodules. At histology, 16 nodules were malignant and 49 nodules were benign. The intra and inter-observer correlations of elastosonography were excellent. The sensitivity, specificity, PPV, NPV of sonoelastography were 87.5%, 98%, 93.3%, 96%, respectively comparing with 100%, 93.9%, 84%, 100% of Mode B sonography. Thus, 95% (36/38 nodules) of BI-RADS 3 nodules were reclassified score 2 or 1 with elastosonography, decreasing the rates of fine needle aspiration and short-term follow-up. Elastosonography is a simple, rapid and complementary method to mode B sonography that can improve the specificity in the characterization of breast nodules and the management of BI-RADS 3 nodules, leading to a decrease of false-positive and short term follow-up rates.
我们通过组织学相关性评估超声弹性成像在乳腺结节特征描述中的性能。由两名放射科医生对59例患者（65个结节）在B型超声检查后立即独立进行弹性超声检查。记录所有弹性超声检查序列。计算观察者内和观察者间的相关性。每个结节按照乳腺影像报告和数据系统（BI-RADS）词典以及上野弹性成像分类进行分类。将1-3分视为良性，4-5分视为恶性。所有结节均有细胞学/组织学诊断结果。组织学检查显示，16个结节为恶性，49个结节为良性。弹性超声检查的观察者内和观察者间相关性极佳。与B型超声检查的敏感性、特异性、阳性预测值、阴性预测值分别为100%、93.9%、84%、100%相比，超声弹性成像的相应指标分别为87.5%、98%、93.3%、96%。因此，95%（36/38个结节）的BI-RADS 3类结节通过弹性超声检查重新分类为2类或1类，从而降低了细针穿刺率和短期随访率。弹性超声成像是一种简单、快速且对B型超声检查具有补充作用的方法，可提高乳腺结节特征描述的特异性以及BI-RADS 3类结节的管理水平，进而降低假阳性率和短期随访率。
