Department of Radiology, CHA Bundang Medical Center, CHA University, School of Medicine, 351 Yatapdong, Bundang-gu, Seongnam-si, Gyeonggi-do 463-712, Korea.
Eur Radiol. 2013 Jul;23(7):1803-11. doi: 10.1007/s00330-013-2782-5. Epub 2013 Feb 20.
To evaluate which shear wave elastography (SWE) parameter proves most accurate in the differential diagnosis of solid breast masses.
One hundred and fifty-six breast lesions in 139 consecutive women (mean age: 43.54 ± 9.94 years, range 21-88 years), who had been scheduled for ultrasound-guided breast biopsy, were included. Conventional ultrasound and SWE were performed in all women before biopsy procedures. Ultrasound BI-RADS final assessment and SWE parameters were recorded. Diagnostic performance of each SWE parameter was calculated and compared with those obtained when applying cut-off values of previously published data. Performance of conventional ultrasound and ultrasound combined with each parameter was also compared.
Of the 156 breast masses, 120 (76.9 %) were benign and 36 (23.1 %) malignant. Maximum stiffness (Emax) with a cut-off of 82.3 kPa had the highest area under the receiver operating characteristics curve (Az) value compared with other SWE parameters, 0.860 (sensitivity 88.9 %, specificity 77.5 %, accuracy 80.1 %). Az values of conventional ultrasound combined with each SWE parameter showed lower (but not significantly) values than with conventional ultrasound alone.
Maximum stiffness (82.3 kPa) provided the best diagnostic performance. However the overall diagnostic performance of ultrasound plus SWE was not significantly better than that of conventional ultrasound alone.
• SWE offers new information over and above conventional breast ultrasound • Various SWE parameters were explored regarding distinction between benign and malignant lesions • An elasticity of 82.3 kPa appears optimal in differentiating solid breast masses • However, ultrasound plus SWE was not significantly better than conventional ultrasound alone.
评估剪切波弹性成像（SWE）参数在鉴别实性乳腺肿块中的准确性。
纳入 139 例连续女性患者（平均年龄：43.54±9.94 岁，范围 21-88 岁）的 156 个乳腺病变，这些患者均拟行超声引导下乳腺活检。所有患者均在活检前进行常规超声和 SWE 检查。记录超声 BI-RADS 最终评估和 SWE 参数。计算各 SWE 参数的诊断性能，并与应用先前发表数据的截断值时获得的结果进行比较。还比较了常规超声和常规超声联合各参数的诊断性能。
156 个乳腺肿块中，120 个（76.9%）为良性，36 个（23.1%）为恶性。最大硬度（Emax）截断值为 82.3 kPa 时，与其他 SWE 参数相比，其获得的受试者工作特征曲线（Az）值最高（0.860，敏感性 88.9%，特异性 77.5%，准确性 80.1%）。与单独使用常规超声相比，常规超声联合各 SWE 参数的 Az 值较低（但无统计学意义）。
最大硬度（82.3 kPa）提供了最佳的诊断性能。然而，超声联合 SWE 的整体诊断性能并不明显优于单独使用常规超声。
• SWE 提供了常规乳腺超声之外的新信息。
• 探讨了各种 SWE 参数在鉴别良性和恶性病变方面的应用。
• 在鉴别实性乳腺肿块方面，弹性值为 82.3 kPa 似乎最佳。
• 然而，超声联合 SWE 并不明显优于单独使用常规超声。
