Department of Ultrasound, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong Province, China.
Clin Breast Cancer. 2013 Oct;13(5):392-400. doi: 10.1016/j.clbc.2013.02.015. Epub 2013 Jul 3.
Through analysis, the elastograms characteristics of breast lesions of Chinese women, a suitable diagnostic standard of quasistatic ultrasound elastography (UE) for Chinese women was proposed.
From June 2010 to March 2012, 1036 consecutive female patients (mean age, 44 years old) with breast lesions were recruited into a multicenter retrospective study, which involved 8 centers across China. Each institutional ethic review board approved the study, and all the patients gave written informed consent. All breast lesions underwent ultrasound and UE examination. Two radiologists analyzed the elastograms and separated the elastograms into 10 types. A final diagnosis was made on the basis of histologic findings. The characteristics of the elastograms were analyzed. Receiver operating characteristic curves were plotted for evaluating the diagnostic performance. Sensitivity, specificity, and accuracy were calculated. Differences in sensitivity, specificity, and accuracy were tested by using the McNemar test.
There were 1150 lesions (593 benign, 557 malignant). There was a highly significant correlation between the elastogram color distribution and the percentage of malignant lesions, with a value of 0.92 (2P < .0001). Through analysis the different malignant percentages in different elastogram types, UE diagnostic standard was proposed, which was correlated with the blue percentage in the elastogram. The specificity, sensitivity, and accuracy of UE were 86.4%, 80.8%, and 83.5%, respectively. The specificity and accuracy of UE were higher than with ultrasound. The area under the curve was 0.86.
UE could give valuable assessment in the diagnosis of breast lesions. The proposed UE diagnostic standard was suitable for Chinese women.
通过分析，得出中国女性乳腺病变声触诊组织量化图的特征，提出适合中国女性的准静态超声弹性成像（UE）诊断标准。
本研究为多中心回顾性研究，自 2010 年 6 月至 2012 年 3 月，连续纳入 1036 例经病理证实的女性乳腺病变患者，年龄（44.3±11.2）岁。所有患者均签署知情同意书，研究经各中心伦理委员会批准。所有患者均行超声及 UE 检查。由 2 名超声医师分析声触诊组织量化图并将其分为 10 型，以病理结果为金标准，分析声触诊组织量化图特征，绘制受试者工作特征曲线评价诊断效能，计算敏感度、特异度及准确率，采用 McNemar 检验比较不同诊断方法的敏感度、特异度及准确率。
共 1150 个病灶（良性 593 个，恶性 557 个）。声触诊组织量化图的颜色分布与恶性病灶百分比之间具有高度相关性，其相关系数为 0.92（2P<0.0001）。分析不同类型声触诊组织量化图中恶性病灶的百分比，提出了与声触诊组织量化图蓝色百分比相关的 UE 诊断标准。UE 的特异度、敏感度及准确率分别为 86.4%、80.8%及 83.5%，其特异度及准确率均高于超声。曲线下面积为 0.86。
UE 可为乳腺病变的诊断提供有价值的评估，提出的 UE 诊断标准适用于中国女性。
