Department of Radiology, Research Institute of Radiological Science, Yonsei University, College of Medicine, Seoul, Republic of Korea.
Ultraschall Med. 2013 Jun;34(3):266-71. doi: 10.1055/s-0032-1312948. Epub 2012 Jun 21.
To evaluate the rate of the elastography-pathology discordance, and evaluate which various factors have an effect on discordant elastography images (DEI) of breast lesions.
Elastography images of 284 pathologically confirmed breast lesions of 233 patients were evaluated. Elasticity scores were compared to pathology results, and lesions were divided into 4 groups: benign concordant/discordant, and malignant concordant/discordant. The rate of DEI among benign and malignant lesions was calculated and compared. Patient, lesion factors and image adequacy were compared among the concordant and discordant groups for analysis.
Among the 284 breast lesions, 225 (79.2%) were benign, and 59 (20.8%) were malignant. The rate of DEI among malignant lesions was significantly higher than in benign lesions, i. e., 52.5 vs. 3.1% (p < 0.001). Discordant images were more significantly seen in patients with extremely dense breasts on mammography in benign lesions, 42.9 vs. 11.9% (p = 0.034). Discordant images were more significantly seen in malignant lesions < 10 mm or ≥ 20 mm (p = 0.006), and those with inadequate images (64.5 vs. 35.5%, p < 0.001).
The rate of DEI was higher in malignant lesions than in benign lesions. Dense breast parenchyma, lesion size and image adequacy showed significance in discordant images of elastography which need consideration in image acquisition and interpretation.
评估超声弹性成像与病理结果不一致的比率，并探讨哪些因素会影响乳腺病变的不一致性弹性成像图。
回顾性分析 233 例患者 284 个经病理证实的乳腺病灶的超声弹性成像图。将弹性评分与病理结果进行比较，将病灶分为良性组（包括良性一致/不一致）和恶性组（包括恶性一致/不一致）。计算并比较良性和恶性病灶的不一致性弹性成像图的发生率。对良性和恶性病灶的一致性和不一致性组的患者、病灶因素和图像质量进行比较分析。
284 个乳腺病灶中，225 个（79.2%）为良性，59 个（20.8%）为恶性。恶性病灶的不一致性弹性成像图发生率明显高于良性病灶，分别为 52.5%和 3.1%（p < 0.001）。在良性病灶中，乳腺 X 线摄影表现为致密型乳腺的患者，其不一致性弹性成像图更为显著，分别为 42.9%和 11.9%（p = 0.034）。恶性病灶中，直径<10 mm 或≥20 mm 的病灶，以及图像质量不足的病灶（分别为 64.5%和 35.5%，p < 0.001），其不一致性弹性成像图更为显著。
恶性病灶的不一致性弹性成像图发生率高于良性病灶。致密型乳腺实质、病灶大小和图像质量在超声弹性成像的不一致性图像中具有显著意义，在获取和解释图像时需要考虑这些因素。
