Department of Diagnostic Radiology, (L.C.H.L., T.H.L., L.S.-J.S.) and Division of Pathology (P.H.T.), Singapore.
General Hospital, Duke-NUS Medical School, Singapore.
J Ultrasound Med. 2019 Jul;38(7):1779-1790. doi: 10.1002/jum.14867. Epub 2018 Nov 28.
The aim of this study was to compare the diagnostic performance of strain elastographic techniques involving pattern-based elastography versus size ratio elastography on breast masses.
Female patients presenting to the radiology department for ultrasound (US)-guided biopsies, fine-needle aspirations, or localizations of breast masses were invited to undergo US elastographic assessments of the lesions before the breast procedures. The masses were evaluated for color score and color map size ratio elastographic assessments with one US machine and size ratio and grayscale strain pattern elastographic assessments with another machine. With the histopathologic diagnosis as the reference standard, the sensitivity, specificity, and area under the receiver operating characteristic curve were compared among the 4 groups.
A total of 154 breast masses from 139 women were assessed. The sensitivity and specificity were 0.615 (95% confidence interval, 0.470-0.747) and 0.824 (0.736-0.892), respectively for the color score, 0.962 (0.868-0.995) and 0.765 (0.670-0.843) for the size ratio, 0.904 (0.790-0.968) and 0.745 (0.649-0.826) for the color map size ratio, and 0.635 (0.490-0.764) and 0.422 (0.324-0.523) for the grayscale strain pattern. The areas under the receiver operating characteristic curve were 0.729 for the color score, 0.874 for the size ratio (P = .001 with the color score as a reference), 0.836 for the color map size ratio (P = .002), and 0.556 for the grayscale strain pattern (P < .001).
Size ratio elastography had higher sensitivity and better diagnostic accuracy compared to color score elastography. This superiority was demonstrated on two different US systems, and size ratio elastography should thus be considered over color score elastography in the adjunctive US assessment of breast lesions.
本研究旨在比较基于模式的弹性成像与大小比弹性成像这两种应变弹性技术在乳腺肿块中的诊断性能。
本研究邀请了因超声（US）引导下活检、细针抽吸或乳腺肿块定位而到放射科就诊的女性患者，在进行乳腺操作前对病变进行 US 弹性评估。使用一台 US 机评估彩色评分和彩色图大小比弹性，使用另一台机器评估大小比和灰阶应变模式弹性，评估病变的彩色评分和彩色图大小比弹性。以组织病理学诊断为参考标准，比较 4 组间的敏感性、特异性和受试者工作特征曲线下面积。
共评估了 139 名女性的 154 个乳腺肿块。彩色评分的敏感性和特异性分别为 0.615（95%置信区间，0.470-0.747）和 0.824（0.736-0.892），大小比的敏感性和特异性分别为 0.962（0.868-0.995）和 0.765（0.670-0.843），彩色图大小比的敏感性和特异性分别为 0.904（0.790-0.968）和 0.745（0.649-0.826），灰阶应变模式的敏感性和特异性分别为 0.635（0.490-0.764）和 0.422（0.324-0.523）。受试者工作特征曲线下面积分别为彩色评分 0.729、大小比 0.874（与彩色评分相比，P=0.001）、彩色图大小比 0.836（P=0.002）和灰阶应变模式 0.556。
与彩色评分弹性成像相比，大小比弹性成像具有更高的敏感性和更好的诊断准确性。这种优势在两种不同的 US 系统上得到了证明，因此，在乳腺病变的辅助 US 评估中，应考虑使用大小比弹性成像而非彩色评分弹性成像。
