Department of Ultrasound, Shanghai Huashan Hospital, Fudan University, 12 Urumqi Zhong Rd, Jing'an District, 200040 Shanghai, China. y_wang1111@hotmailcom.
J Ultrasound Med. 2013 Dec;32(12):2171-6. doi: 10.7863/ultra.32.12.2171.
The purpose of this study was to explore the clinical value of real-time ultrasound elastography in differentiating malignant from benign breast tumors and to determine an optimal cutoff for the traced area ratio by receiver operator characteristic (ROC) analysis for differential diagnosis between malignant and benign breast masses.
From October 2010 to June 2011, 102 patients with 192 breast tumors were enrolled. Conventional sonograms and real-time elastograms were obtained from the patients. The sensitivity, specificity, and accuracy rates for sonography and elastography were calculated, and an ROC analysis was performed.
Tumors with an elasticity grade of 4 or higher were defined as malignant. The sensitivity, specificity, and accuracy of elastography were 92.65%, 73.39%, and 81.25%, respectively. These values were similar to those for conventional sonography. However, when the techniques were combined, the sensitivity, specificity, and accuracy increased to 88.23%, 95.97%, and 93.23%. A value of 1.65 was determined to be the traced area ratio cutoff by the ROC analysis and was used in this study for differential diagnosis. The sensitivity, specificity, and accuracy of this value were 76.47%, 96.77%, and 89.58%, respectively.
Both conventional sonography and ultrasound elastography could be used to differentiate malignant and benign breast tumors. If these techniques were combined, the diagnostic values would improve. In addition, a traced area ratio of 1.65 could be used as a cutoff to differentiate benign and malignant breast tumors.
本研究旨在探讨实时超声弹性成像在鉴别良恶性乳腺肿瘤中的临床价值，并通过受试者工作特征（ROC）分析确定用于鉴别良恶性乳腺肿块的最佳 traced area ratio 截断值。
2010 年 10 月至 2011 年 6 月，共纳入 102 例 192 个乳腺肿瘤患者。对患者进行常规超声和实时弹性成像检查。计算超声和弹性成像的灵敏度、特异度和准确率，并进行 ROC 分析。
弹性评分 4 级或 4 级以上的肿瘤定义为恶性。弹性成像的灵敏度、特异度和准确率分别为 92.65%、73.39%和 81.25%，与常规超声相似。然而，当两种技术联合使用时，灵敏度、特异度和准确率提高至 88.23%、95.97%和 93.23%。ROC 分析确定 traced area ratio 截断值为 1.65，并在本研究中用于鉴别诊断。该值的灵敏度、特异度和准确率分别为 76.47%、96.77%和 89.58%。
常规超声和超声弹性成像均可用于鉴别良恶性乳腺肿瘤。如果将这两种技术联合使用，诊断价值会提高。此外，traced area ratio 为 1.65 可作为鉴别良恶性乳腺肿瘤的截断值。
