Zhao Qing, Wang Xiao-Lei, Sun Jia-Wei, Jiang Zhao-Peng, Tao Lin, Zhou Xian-Li
In-Patient Ultrasound Department, Second Affiliated Hospital of Harbin Medical University, Nan Gang, Harbin, Heilongjiang, China.
Clin Hemorheol Microcirc. 2018;70(1):39-50. doi: 10.3233/CH-170364.
To compare the diagnostic performance of conventional strain elastography (CSE) and acoustic radiation force impulse (ARFI) induced SE for qualitative assessment of breast lesions and evaluate the additional value of the two techniques combined with Breast Imaging Reporting and Data System (BI-RADS) respectively for the differentiation of benign and malignant breast lesions.
In a cohort of 110 women, the conventional ultrasound (US) features and the elasticity scores of CSE and ARFI induced SE were recorded. The diagnostic performances of BI-RADS, elastography and BI-RADS plus elastography were evaluated, including the area under the receiver operating characteristic curve (AUROC), sensitivity, specificity and accuracy.
Pathologically, there were forty-eight malignant and sixty-two benign breast lesions in the final analysis. The AUCs for CSE and ARFI induced SE are similar (CSE, 0.807; ARFI induced SE, 0.846; p > 0.05), however, the specificity of the latter method was significantly higher than that of CSE (83.9% vs. 58.1%, p = 0.004) in differentiating breast lesions. The accuracy and specificity of BI-RADS plus ARFI induced SE (84.5%, 80.6%, respectively) were significantly higher than BI-RADS alone (73.6%, 54.8%, respectively) and BI-RADS plus conventional SE (72.7%, 56.5%, respectively), respectively (p < 0.05) without loss of sensitivity.
Our study showed that BI-RADS plus ARFI induced SE had a better diagnostic performance in the diagnosis of breast lesions in comparison with BI-RADS alone or BI-RADS plus CSE.
比较传统应变弹性成像（CSE）和声学辐射力脉冲（ARFI）诱导的弹性成像对乳腺病变进行定性评估的诊断性能，并分别评估这两种技术与乳腺影像报告和数据系统（BI-RADS）联合应用对乳腺良恶性病变鉴别的附加价值。
对110名女性进行研究，记录其常规超声（US）特征以及CSE和ARFI诱导的弹性成像的弹性评分。评估BI-RADS、弹性成像以及BI-RADS加弹性成像的诊断性能，包括受试者操作特征曲线下面积（AUROC）、敏感性、特异性和准确性。
最终分析病理结果显示，有48例恶性乳腺病变和62例良性乳腺病变。CSE和ARFI诱导的弹性成像的AUC相似（CSE为0.807；ARFI诱导的弹性成像为0.846；p>0.05），然而，在鉴别乳腺病变时，后一种方法的特异性显著高于CSE（分别为83.9%和58.1%，p=0.004）。BI-RADS加ARFI诱导的弹性成像的准确性和特异性（分别为84.5%、80.6%）显著高于单独的BI-RADS（分别为73.6%、54.8%）和BI-RADS加传统弹性成像（分别为72.7%、56.5%）（p<0.05），且不损失敏感性。
我们的研究表明，与单独的BI-RADS或BI-RADS加CSE相比，BI-RADS加ARFI诱导的弹性成像在乳腺病变诊断中具有更好的诊断性能。
