Department of Ultrasound, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiangxi Rd, Guangzhou 510120, Guangdong Province, China.
Eur J Radiol. 2012 Nov;81(11):3216-21. doi: 10.1016/j.ejrad.2012.04.016. Epub 2012 May 17.
To evaluate the additive value of ultrasound strain elastography (USE) to BI-RADS for the differentiation of benign and malignant breast small lesions.
Breast masses (≤2 cm) with histological diagnosis examined by ultrasonography and USE in our department from April 2004 to December 2009 were reviewed. Conventional B-mode ultrasound findings were classified according to the BI-RADS classification. USE findings were classified according to the 5-point scale. Histological diagnosis was used as the reference standard.
401 (246 benign (61.3%), 155 malignant (38.7%)) from 370 consecutive patients were included in the study. Sensitivity and specificity were 90.3%, 68.3% for BI-RADS; 72.3%, 91.9% for USE. The sensitivity of BI-RADS was better than that of USE (P<0.05), while the specificity of USE was better than that of BI-RADS (P<0.05). A revised BI-RADS combined with USE results was proposed in this study. Sensitivity and specificity were 83.9% and 87.8% for revised BI-RADS. The diagnostic performance of revised BI-RADS was better than BI-RADS (P<0.05).
USE could give BI-RADS some help in the differentiation of benign and malignant breast small lesions. The addition of elastography to BI-RADS could improve the diagnostic performance in <2 cm lesions.
评估超声应变弹性成像（USE）对 BI-RADS 对良恶性乳腺小病灶的鉴别诊断的附加价值。
回顾 2004 年 4 月至 2009 年 12 月我科经超声和 USE 检查并有组织学诊断的乳腺肿块（≤2cm）。根据 BI-RADS 分类对常规 B 型超声表现进行分类。根据 5 分制对 USE 结果进行分类。组织学诊断为参考标准。
401 例（246 例良性（61.3%），155 例恶性（38.7%））连续患者纳入研究。BI-RADS 的敏感性和特异性分别为 90.3%，68.3%；USE 分别为 72.3%，91.9%。BI-RADS 的敏感性优于 USE（P<0.05），而 USE 的特异性优于 BI-RADS（P<0.05）。本研究提出了一种改良的 BI-RADS 联合 USE 结果。改良 BI-RADS 的敏感性和特异性分别为 83.9%和 87.8%。改良 BI-RADS 的诊断性能优于 BI-RADS（P<0.05）。
USE 可对 BI-RADS 鉴别良恶性乳腺小病灶提供一定帮助。在<2cm 病变中，将弹性成像添加到 BI-RADS 中可提高诊断性能。
