Department of Radiology, Antalya Training and Research Hospital, Health Sciences University, Antalya, Turkey.
Department of Radiology, Antalya Training and Research Hospital, Health Sciences University, Antalya, Turkey; Department of Radiology, Loyola University Medical Center, Maywood, Illinois, USA.
Diagn Interv Imaging. 2017 Oct;98(10):685-691. doi: 10.1016/j.diii.2017.06.009. Epub 2017 Jul 17.
The goal of this study was to investigate the strain elastography imaging characteristics of idiopathic granulomatous mastitis (IGM) and compare strain ratio values of IGM with those of breast cancer.
Twenty-three consecutive women with IGM (mean age, 37.9±6.6 [SD] years; range: 26-52 years) and 45 women with malignant breast tumor (mean age, 52.8±12.0 [SD], range, 32-77 years) who had been scheduled for ultrasound-guided core biopsy were recruited to the study. All had ultrasonography with elastography before biopsy. The strain ratios of lesions were calculated using surrounding normal breast tissue as the reference in both groups and compared between the two groups. Receiver-operating-characteristics (ROC) curves were formed. Sensitivity, specificity, cut-off, and area under curve (AUC) values were calculated.
The mean strain ratio on sonoelastography was 1.5±0.8 (SD) (range: 0.2-4.0) for IGM and 5.3±5.2 (SD) (range: 1.4-33) for malignant lesions. Strain ratio values in IGM lesions were significantly lower than in malignant lesions (P˂0.05). ROC test yielded an AUC value of 0.939 (95% confidence interval, 0.882-0.995; P<0.0001). Optimal cut-off value for strain ratio value was 2.5 yielding 87% sensitivity and 96% specificity for the diagnosis of IGM.
Sonoelastographic strain ratio contributes to differentiate IGM from malignant breast lesions, thus has potential to influence clinical decision making for further biopsies.
本研究旨在探讨特发性肉芽肿性乳腺炎（IGM）的应变弹性成像特征，并比较 IGM 与乳腺癌的应变比值。
连续纳入 23 例 IGM 患者（平均年龄 37.9±6.6[SD]岁，范围：26-52 岁）和 45 例拟行超声引导下粗针活检的恶性乳腺肿瘤患者（平均年龄 52.8±12.0[SD]，范围：32-77 岁）。所有患者均在活检前行超声弹性成像检查。在两组中，均以周围正常乳腺组织为参照，计算病变的应变比值，并比较两组之间的差异。绘制受试者工作特征（ROC）曲线。计算敏感性、特异性、截断值和曲线下面积（AUC）值。
IGM 病变的平均应变比在声弹性成像上为 1.5±0.8（SD）（范围：0.2-4.0），恶性病变为 5.3±5.2（SD）（范围：1.4-33）。IGM 病变的应变比值明显低于恶性病变（P<0.05）。ROC 试验得到的 AUC 值为 0.939（95%置信区间，0.882-0.995；P<0.0001）。应变比值的最佳截断值为 2.5，用于诊断 IGM 的敏感性为 87%，特异性为 96%。
声弹性成像应变比值有助于鉴别 IGM 与恶性乳腺病变，因此有可能影响进一步活检的临床决策。
