Chung Se Yeong, Moon Woo Kyung, Choi Ji Won, Cho Nariya, Jang Mijung, Kim Kwang Gi
Department of Radiology, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea.
Acta Radiol. 2010 Feb;51(1):9-14. doi: 10.3109/02841850903273966.
Elastography has shown potential in differentiating benign from malignant breast tumors, but interobserver variability between experienced and inexperienced readers limits its wide usage.
To compare the diagnostic performance of computer-assisted quantification and visual assessment of lesion stiffness with the use of sonographic elastography for the differentiation of benign from malignant nonpalpable breast masses.
Sonographic elasticity images of 120 nonpalpable breast masses (70 benign and 50 malignant masses) were obtained in 120 women prior to performing a core biopsy. After subtraction of B-mode images from color elasticity images, the mean strain value of the lesion was computed. Elasticity images were also reviewed and were assigned a score on a five-point scale by two breast radiologists in consensus. Results were evaluated by using receiver operating characteristic (ROC) curve analysis.
The mean +/- standard deviation values of strain were 221+/-18 for malignant lesions and 175+/-21 for benign lesions (P<0.001). For the elasticity score, the mean score was 3.5+/-0.1 for the malignant masses and 2.0+/-0.9 for the benign masses (P<0.001). The overall Pearson's correlation coefficient between the strain values and elasticity score was 0.689 (P<0.001). The area under the ROC curve (A(z)) value was 0.878 for use of the computer-assisted quantification method and 0.850 for visual assessment by the radiologists. The difference was not statistically significant (P=0.198).
Computer-assisted quantification and visual assessment of lesion stiffness with the use of sonographic elasticity images had comparable diagnostic performance for the differentiation of nonpalpable breast masses.
弹性成像在鉴别乳腺良恶性肿瘤方面已显示出潜力，但经验丰富和缺乏经验的读者之间的观察者间变异性限制了其广泛应用。
比较使用超声弹性成像对不可触及乳腺肿块进行计算机辅助定量分析和病变硬度视觉评估的诊断性能，以鉴别乳腺良恶性肿块。
在对120名女性进行粗针活检之前，获取了120个不可触及乳腺肿块（70个良性和50个恶性肿块）的超声弹性图像。从彩色弹性图像中减去B模式图像后，计算病变的平均应变值。两名乳腺放射科医生还对弹性图像进行了评估，并共同给予了五分制评分。通过使用受试者操作特征（ROC）曲线分析来评估结果。
恶性病变的平均应变值±标准差为221±18，良性病变为175±21（P<0.001）。对于弹性评分，恶性肿块的平均评分为3.5±0.1，良性肿块为2.0±0.9（P<0.001）。应变值与弹性评分之间的总体皮尔逊相关系数为0.689（P<0.001）。使用计算机辅助定量分析方法时，ROC曲线下面积（A(z)）值为0.878，放射科医生视觉评估时为0.850。差异无统计学意义（P=0.198）。
使用超声弹性图像对病变硬度进行计算机辅助定量分析和视觉评估，在鉴别不可触及乳腺肿块方面具有相当的诊断性能。
