Choi Hye Jeong, Ko Kyung Hee, Jung Hae Kyoung
Department of Radiology, CHA Bundang Medical Center, CHA University, Bundang-gu, Korea.
J Ultrasound Med. 2017 Oct;36(10):2007-2014. doi: 10.1002/jum.14293. Epub 2017 Jul 14.
To evaluate the effectiveness of shear wave elastography (SWE) for differentiating benign from malignant breast papillary lesions METHODS: B-mode ultrasound (US) and SWE were available in 56 surgically confirmed papillary lesions (48 [85.7%] benign and 8 [14.3%] malignant). The diagnostic performances of US, SWE parameters, and combined US with SWE parameters were calculated by receiver operating characteristic curve analysis and compared.
The highest area under the receiver operating characteristic curve (A ) value for US was 0.500 (95% confidence interval [CI], 0.363, 0.637). The sensitivity was 100% (8 of 8), and the specificity was 0% (0 of 48). False-positive biopsy results were obtained in 48 (85.7%) of 56 lesions. The A value for mean elasticity (0.721; 95% CI, 0.585, 0.833) was higher than that for B-mode US (P < .01) and the highest with the optimal cutoff value of 44.3 kPa (sensitivity, 75%; specificity, 75%). By adding the mean elasticity cutoff value of 44.3 kPa to B-mode US, the performance was increased (A , 0.781; 95% CI, 0.585, 0.833) with sensitivity of 87.5% and specificity of 68.8%, and false-positive biopsy results were reduced to 26.8%.
The additional use of SWE to B-mode US may be effective for differentiating benign and malignant breast papillary lesions, with a significant decrease in the false-positive biopsy rate.
评估剪切波弹性成像（SWE）鉴别乳腺乳头状病变良恶性的有效性。方法：对56例经手术证实的乳头状病变（48例[85.7%]为良性，8例[14.3%]为恶性）进行B超（US）和SWE检查。通过绘制受试者工作特征曲线分析计算US、SWE参数以及联合US与SWE参数的诊断性能，并进行比较。
US的受试者工作特征曲线下面积（A）最高值为0.500（95%置信区间[CI]，0.363，0.637）。敏感性为100%（8/8），特异性为0%（0/48）。56例病变中有48例（85.7%）活检结果为假阳性。平均弹性值的A值（0.721；95%CI，0.585，0.833）高于B超（P＜0.01），最佳截断值为44.3kPa时A值最高（敏感性75%，特异性75%）。将平均弹性截断值44.3kPa加入B超中，性能提高（A，0.781；95%CI，0.585，0.833），敏感性为87.5%，特异性为68.8%，活检假阳性结果降至26.8%。
在B超基础上联合使用SWE可能有助于鉴别乳腺乳头状病变的良恶性，显著降低活检假阳性率。
