Skerl K, Vinnicombe S, Giannotti E, Thomson K, Evans A
Medical Research Institute, Ninewells Hospital & Medical School, Mailbox 4, Dundee DD1 9SY, UK.
Medical Research Institute, Ninewells Hospital & Medical School, Mailbox 4, Dundee DD1 9SY, UK.
Clin Radiol. 2015 Dec;70(12):1421-7. doi: 10.1016/j.crad.2015.08.010. Epub 2015 Oct 9.
To evaluate the influence of the region of interest (ROI) size and lesion diameter on the diagnostic performance of 2D shear wave elastography (SWE) of solid breast lesions.
A study group of 206 consecutive patients (age range 21-92 years) with 210 solid breast lesions (70 benign, 140 malignant) who underwent core biopsy or surgical excision was evaluated. Lesions were divided into small (diameter <15 mm, n=112) and large lesions (diameter ≥15 mm, n=98). An ROI with a diameter of 1, 2, and 3 mm was positioned over the stiffest part of the lesion. The maximum elasticity (Emax), mean elasticity (Emean) and standard deviation (SD) for each ROI size were compared to the pathological outcome. Statistical analysis was undertaken using the chi-square test and receiver operating characteristic (ROC) analysis.
The ROI size used has a significant impact on the performance of Emean and SD but not on Emax. Youden's indices show a correlation with the ROI size and lesion size: generally, the benign/malignant threshold is lower with increasing ROI size but higher with increasing lesion size.
No single SWE parameter has superior performance. Lesion size and ROI size influence diagnostic performance.
评估感兴趣区域（ROI）大小和病变直径对乳腺实性病变二维剪切波弹性成像（SWE）诊断性能的影响。
对206例连续患者（年龄范围21 - 92岁）进行研究，这些患者有210个乳腺实性病变（70个良性，140个恶性），均接受了粗针活检或手术切除。病变分为小病变（直径<15 mm，n = 112）和大病变（直径≥15 mm，n = 98）。将直径为1、2和3 mm的ROI放置在病变最硬的部分。比较每个ROI大小的最大弹性（Emax）、平均弹性（Emean）和标准差（SD）与病理结果。采用卡方检验和受试者操作特征（ROC）分析进行统计分析。
所使用的ROI大小对Emean和SD的性能有显著影响，但对Emax无影响。约登指数显示与ROI大小和病变大小相关：一般来说，随着ROI大小增加，良性/恶性阈值降低，但随着病变大小增加，良性/恶性阈值升高。
没有单一的SWE参数具有卓越性能。病变大小和ROI大小影响诊断性能。
