Department of Radiology, CHA Bundang Medical Center, CHA University, 59 Yatap-ro, Bundang-gu, Seongnam-si, Gyeonggi-do 13496, Korea.
Department of Pathology, CHA Bundang Medical Center, CHA University, Seongnam-si, Gyeonggi-do, Korea.
Acad Radiol. 2020 Apr;27(4):487-496. doi: 10.1016/j.acra.2019.06.009. Epub 2019 Jul 9.
To investigate if preoperative ultrasonographic vascular and shear-wave elastographic examinations can predict histologic aggressiveness.
Preoperative ultrasonographic vascular features and shear-wave elasticities were retrospectively evaluated for 147 invasive ductal carcinomas. Vascular feature was assessed using four-tier vascularity score. Mean and maximum elasticities (Emean and Emax), and the lesion-to-fat ratio (Eratio) were documented. Histologic parameters were reviewed for tumor size, multiplicity, axillary lymph node status, lymphovascular invasion, histologic grade, estrogen receptor, progesterone receptor, human epidermal growth factor receptor2 (HER2), Ki-67, p53, and histologic subtype. Vascularity score and elasticities were correlated with histologic parameters and histologic parameters were compared between the group with low vascularity score and elasticities and the group with high vascularity score and elasticities using ANOVA, chi-squared test, and regression analysis.
Vascularity score was independently associated with tumor size (p = 0.010) and HER2 (p = 0.007). Emean and Emax were associated with tumor size, histologic grade, and lymphovascular invasion, and Eratio was associated with tumor size, histologic grade, estrogen receptor, progesterone receptor, Ki-67, and histologic subtype (p < 0.05). Emean and Emax were independently associated with tumor size (p < 0.001). The group with high vascularity score and Eratio showed large tumor size (p < 0.001) and HER2 positivity (p = 0.039) in comparison to the group with low vascularity score and Eratio.
Ultrasonographic vascular features were associated with tumor size and HER2. SWE elasticities were associated with tumor size, histologic grade, hormonal receptor, and histologic subtype. Therefore, preoperative vascular and elastographic examinations could predict histologic aggressiveness of invasive ductal breast carcinoma.
研究术前超声血管和剪切波弹性成像是否可预测组织学侵袭性。
回顾性评估了 147 例浸润性导管癌的术前超声血管特征和剪切波弹性。使用四级血管评分评估血管特征。记录平均和最大弹性（Emean 和 Emax）以及病变与脂肪比（Eratio）。评估组织学参数包括肿瘤大小、多发性、腋窝淋巴结状态、淋巴管血管侵犯、组织学分级、雌激素受体、孕激素受体、人表皮生长因子受体 2（HER2）、Ki-67、p53 和组织学亚型。血管评分和弹性与组织学参数相关，使用方差分析、卡方检验和回归分析比较低血管评分和弹性组与高血管评分和弹性组之间的组织学参数。
血管评分与肿瘤大小（p = 0.010）和 HER2（p = 0.007）独立相关。Emean 和 Emax 与肿瘤大小、组织学分级和淋巴管血管侵犯相关，Eratio 与肿瘤大小、组织学分级、雌激素受体、孕激素受体、Ki-67 和组织学亚型相关（p < 0.05）。Emean 和 Emax 与肿瘤大小独立相关（p < 0.001）。与低血管评分和 Eratio 组相比，高血管评分和 Eratio 组的肿瘤较大（p < 0.001）且 HER2 阳性（p = 0.039）。
超声血管特征与肿瘤大小和 HER2 相关。SWE 弹性与肿瘤大小、组织学分级、激素受体和组织学亚型相关。因此，术前血管和弹性检查可预测浸润性导管乳腺癌的组织学侵袭性。
