Navarro Beatriz, Ubeda Belén, Vallespí Mercè, Wolf Casandra, Casas Lilian, Browne Jean L
Gynecologic Diagnostic Imaging Unit, Department of Obstetrics, Gynecology, and Reproduction, Institut Universitari Dexeus, Barcelona, Spain.
J Ultrasound Med. 2011 Mar;30(3):313-21. doi: 10.7863/jum.2011.30.3.313.
The purposes of this study were to evaluate the diagnostic utility of elastography in differentiating benign from malignant breast lesions and compare it with conventional sonography.
A total of 124 breast lesions (59 malignant and 65 benign) were examined with B-mode sonography and subsequently with elastography. Conventional sonographic findings were classified according to the American College of Radiology Breast Imaging Reporting and Data System for sonography, and elastographic images were assigned an elasticity score of 1 to 5 (1-3, benign; 4 and 5, malignant) according to the Ueno classification. Cytologic diagnoses obtained from fine-needle aspiration and histopathologic results from a core-needle biopsy or surgical biopsy were used as reference standards. Statistical analysis included sensitivity, specificity, and positive and negative predictive values for both elastography and conventional sonography.
B-mode sonography had sensitivity of 96.6% (95% confidence interval, 93.3%-99.9%), specificity of 76.9% (69.2%-84.6%), a positive predictive value of 79.2% (72.1%-86.2%), and a negative predictive value of 96.2% (92.4%-99.9%), compared with sensitivity of 69.5% (60.5%-78.5%), specificity of 83.1% (76.3%-89.8%), a positive predictive value of 78.9% (70.6%-87.1%), and a negative predictive value of 75.0% (67.4%-82.6%) for elastography. Elastography showed less sensitivity but higher specificity than conventional sonography.
Our results show that elastography may be useful as a complementary technique in addition to conventional sonography in the characterization of breast lesions because it increases the diagnostic specificity, thus reducing the false-positive rate.
本研究旨在评估弹性成像在鉴别乳腺良恶性病变中的诊断效用，并将其与传统超声检查进行比较。
对124个乳腺病变（59个恶性病变和65个良性病变）进行B超检查，随后进行弹性成像检查。传统超声检查结果根据美国放射学会乳腺影像报告和数据系统进行分类，弹性成像图像根据上野分类法给予1至5分的弹性评分（1 - 3分，良性；4分和5分，恶性）。细针穿刺获得的细胞学诊断结果以及粗针活检或手术活检的组织病理学结果用作参考标准。统计分析包括弹性成像和传统超声检查的敏感性、特异性、阳性预测值和阴性预测值。
B超检查的敏感性为96.6%（95%置信区间，93.3% - 99.9%），特异性为76.9%（69.2% - 84.6%），阳性预测值为79.2%（72.1% - 86.2%），阴性预测值为96.2%（92.4% - 99.9%）；相比之下，弹性成像的敏感性为69.5%（60.5% - 78.5%），特异性为83.1%（76.3% - 89.8%），阳性预测值为78.9%（70.6% - 87.1%），阴性预测值为75.0%（67.4% - 82.6%）。弹性成像显示出比传统超声检查更低的敏感性但更高的特异性。
我们的结果表明，弹性成像除了作为传统超声检查的补充技术外，在乳腺病变的特征描述中可能是有用的，因为它提高了诊断特异性，从而降低了假阳性率。
