Istituto di Radiologia Diagnostica ed Interventistica, Università di Torino, ASO San Giovanni Battista di Torino, Sede Molinette, Via Genova 3, 10126, Torino, Italy.
Radiol Med. 2010 Jun;115(4):551-62. doi: 10.1007/s11547-010-0518-z. Epub 2010 Feb 22.
This study was performed to evaluate the diagnostic accuracy of sonoelastography in differentiating and characterising nodular breast lesions.
A total of 120 nodular lesions diagnosed on mammography and/or ultrasonography in 110 women (mean age 51.27 years) were evaluated with sonoelastography and classified according to elasticity score (S1-S5). Needle biopsy was performed in 104/120 cases, whereas 16/120 were sent for follow-up. Sensitivity and specificity of sonoelastography were determined by taking biopsy findings as the gold standard.
Biopsy yielded the following results: 66 benign, three equivocal and 35 malignant lesions. Sensitivity and specificity of sonoelastography were, respectively, 88.5% and 92.7%. All nodules with an elasticity score of 5 were malignant, and those with a score <or=3 were benign, with the exception of four cases of invasive carcinoma with atypical elasticity (two lobular and two ductal with liquefaction necrosis). Twenty-two lesions were scored 4: 17 were malignant, two equivocal (columnar cell hyperplasia and complex sclerosing lesion) and three benign (sclerotic fibroadenomas).
The use of sonoelastography to complement mammography and ultrasonography could help in the differential diagnosis of nodular breast lesions, especially in Breast Imaging Reporting Data System (BI-RADS) 3 lesions with marked elasticity (S<or=3). In these cases, the high concordance between elastography and cytology or histology in diagnosing benign lesions could reduce the number of needle biopsies and guide women at low radiological risk towards follow-up.
本研究旨在评估超声弹性成像在鉴别和描述结节性乳腺病变中的诊断准确性。
对 110 例女性（平均年龄 51.27 岁）的 120 个乳腺影像学检查（乳腺 X 线摄影和/或超声）诊断为结节性病变进行超声弹性成像评估，并根据弹性评分（S1-S5）进行分类。104/120 例进行了活检，16/120 例进行了随访。以活检结果为金标准，确定超声弹性成像的敏感性和特异性。
活检结果为 66 例良性、3 例可疑和 35 例恶性病变。超声弹性成像的敏感性和特异性分别为 88.5%和 92.7%。所有弹性评分 5 的结节均为恶性，评分<或=3 的结节均为良性，但有 4 例浸润性癌具有非典型弹性（2 例为小叶癌，2 例为导管癌伴液化性坏死）。22 个病变评分为 4：17 例为恶性，2 例为可疑（柱状细胞增生和复杂硬化性病变），3 例为良性（硬化性纤维腺瘤）。
超声弹性成像作为乳腺 X 线摄影和超声检查的补充，有助于鉴别结节性乳腺病变，尤其是在乳腺影像报告和数据系统（BI-RADS）3 类病变中，当弹性评分较高（S<or=3）时。在这些病例中，弹性成像与细胞学或组织学在诊断良性病变方面的高度一致性可以减少活检的数量，并指导低放射风险的女性进行随访。
