Balçık Adile, Polat Ahmet Veysel, Bayrak İlkay Koray, Polat Ayfer Kamalı
Clinic of Radiology, Afyonkarahisar State Hospital, Afyonkarahisar, Turkey.
Department of Radiology, Ondokuz Mayıs University Faculty of Medicine, Samsun, Turkey.
J Breast Health. 2016 Jan 1;12(1):37-43. doi: 10.5152/tjbh.2015.2843. eCollection 2016 Jan.
The study aimed to evaluate the influence of sonoelastographic strain ratio in distinguishing benign from malignant breast masses.
Patients who were referred for diagnostic biopsy of a breast mass were examined by ultrasound and sonoelastography prior to percutaneous biopsy. Sonoelastography was performed twice by the same observer in the same session. The strain ratios (SR) were calculated for both measurements as well as the mean strain ratio. Results were compared with histopathologic findings. For each strain ratio, a threshold value was determined using a ROC analysis for the differentiation of benign and malignant masses.
After histopathological examination of 135 mass lesions in 132 female patients (mean age 48±12 years), 65 masses were diagnosed as benign and 70 as malignant. According to the Tsukuba classification with 5 scores; 44 of 65 benign masses had scores of either 1 or 2 while 56 of 70 malignant lesions had scores of either 4 or 5. No benign lesion was classified as score 5, and no malignant lesion as score 1. The mean cut-off in the two ROC measurements in distinguishing benign from malignant lesions was calculated as 4.52. When a threshold value of 4.52 was used for the mean strain ratio: the sensitivity, specificity, PPV, NPV, and accuracy rates were determined as 85.5%, 84.8%, 85.5%, 84.8% and 85.2%, respectively.
The threshold value for strain ratio in the differentiation of benign and malignant masses was detected as 4.52, and a significant intra-observer difference was not observed in this study. The diagnostic value of sonoelastograghy in distinguishing benign from malignant breast masses was higher in comparison to conventional ultrasound.
本研究旨在评估超声弹性成像应变率在鉴别乳腺良恶性肿块中的作用。
对因乳腺肿块需进行诊断性活检的患者，在经皮活检前进行超声和超声弹性成像检查。同一位观察者在同一时段内进行两次超声弹性成像检查。计算两次测量的应变率（SR）以及平均应变率。将结果与组织病理学结果进行比较。对于每个应变率，使用ROC分析确定鉴别良恶性肿块的阈值。
对132例女性患者（平均年龄48±12岁）的135个肿块病变进行组织病理学检查后，65个肿块诊断为良性，70个为恶性。根据筑波分类法分为5个等级；65个良性肿块中有44个等级为1或2，而70个恶性病变中有56个等级为4或5。没有良性病变被分类为5级，也没有恶性病变被分类为1级。鉴别良恶性病变的两次ROC测量中的平均截断值计算为4.52。当平均应变率的阈值为4.52时：灵敏度、特异度、阳性预测值、阴性预测值和准确率分别确定为85.5%、84.8%、85.5%、84.8%和85.2%。
鉴别乳腺良恶性肿块的应变率阈值检测为4.52，本研究未观察到观察者内的显著差异。与传统超声相比，超声弹性成像在鉴别乳腺良恶性肿块方面具有更高的诊断价值。
