超声造影和剪切波弹性成像对亚厘米级乳腺病变的诊断价值
Diagnostic value of contrast-enhanced ultrasound and shear-wave elastography for breast lesions of sub-centimeter.
作者信息
Xiang Li-Hua, Yao Ming-Hua, Xu Guang, Pu Huan, Liu Hui, Fang Yan, Wu Rong
机构信息
Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Tongji University, Shanghai, China.
Ultrasound Research and Education Institute, Tongji University School of Medicine, Shanghai, China.
出版信息
Clin Hemorheol Microcirc. 2017;67(1):69-80. doi: 10.3233/CH-170250.
BACKGROUND
Contrast-enhanced ultrasound (CEUS) and shear-wave elastography (SWE) are used for diagnostic purposes.
OBJECTIVE
Investigate the diagnostic value of CEUS and SWE for breast lesions of sub-centimeter diameter.
METHODS
Sixty-two patients (mean age: 49.3±12.1 years) with 66 lesions (mean diameter, 8.1±1.5 mm) were analyzed. Conventional ultrasound (US), CEUS and SWE were undertaken. Pathologic specimens were obtained through biopsy or surgery. Lesions were measured in kilopascals. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were analyzed.
RESULTS
For conventional US, the sensitivity was 92.31%, specificity 28.30%, PPV 24.00%, NPV 93.75%, and accuracy 40.90%, whereas those for SWE were 61.54%, 98.11%, 88.89%, 91.23%, and 90.91% (p = 0.000) and CEUS were 92.31%, 60.38%, 36.37%, 96.97%, and 66.67% (p = 0.001), respectively. For SWE + CEUS, the sensitivity was 61.54%, specificity 100.00%, PPV 100.00%, NPV 91.38%, and accuracy 92.42% (p = 0.000). There was a significant difference between US and CEUS (p = 0.004), but not for SWE or SWE + CEUS (p = 0.568; p = 0.205). For SWE + CEUS, there was a significant difference with SWE alone and CEUS alone (p = 0.000; p = 0.008). Between SWE and CEUS, the difference was significant (p = 0.031).
CONCLUSIONS
SWE and CEUS could help to differentiate between malignant and benign breast lesions <1 cm in diameter.
背景
超声造影（CEUS）和剪切波弹性成像（SWE）用于诊断目的。
目的
研究CEUS和SWE对直径小于1厘米的乳腺病变的诊断价值。
方法
分析62例患者（平均年龄：49.3±12.1岁）的66个病变（平均直径，8.1±1.5毫米）。进行了常规超声（US）、CEUS和SWE检查。通过活检或手术获取病理标本。病变以千帕为单位进行测量。分析了敏感性、特异性、阳性预测值（PPV）、阴性预测值（NPV）和准确性。
结果
对于常规US，敏感性为92.31%，特异性为28.30%，PPV为24.00%，NPV为93.75%，准确性为40.90%；而对于SWE，分别为61.54%、98.11%、88.89%、91.23%和90.91%（p = 0.000），对于CEUS分别为92.31%、60.38%、36.37%、96.97%和66.67%（p = 0.001）。对于SWE + CEUS，敏感性为61.54%，特异性为100.00%，PPV为100.00%，NPV为91.38%，准确性为92.42%（p = 0.000）。US和CEUS之间存在显著差异（p = 0.004），但SWE或SWE + CEUS之间无显著差异（p = 0.568；p = 0.205）。对于SWE + CEUS，与单独的SWE和单独的CEUS相比存在显著差异（p = 0.000；p = 0.008）。SWE和CEUS之间差异显著（p = 0.031）。
结论
SWE和CEUS有助于鉴别直径<1厘米的乳腺恶性和良性病变。
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