Crnogorac Maja, Ivanac Gordana, Tomasović-Lončarić Čedna, Žic Rado, Kelava Tomislav, Brkljačić Boris
1Department of Diagnostic and Interventional Radiology, Dubrava University Hospital, Zagreb, Croatia; 2University of Zagreb, School of Medicine, Zagreb, Croatia; 3Department of Pathology, Dubrava University Hospital, Zagreb, Croatia; 4Department of Plastic and Reconstructive Surgery, Dubrava University Hospital, Zagreb, Croatia; 5Department of Physiology and Immunology, University of Zagreb, School of Medicine, Zagreb, Croatia.
Acta Clin Croat. 2019 Mar;58(1):13-22. doi: 10.20471/acc.2019.58.01.02.
The aim of this study was to evaluate the quantitative sonoelastographic values recorded on shear-wave sonoelastography (SWE) of high-risk breast lesions and ductal carcinoma (DCIS). We retrospectively analyzed histopathologic and SWE data (quantitative maximum, minimum and mean stiffness, lesion-to-fat ratio (E-ratio), lesion size) of 228 women referred to our Department for core needle breast biopsy during a four-year period. Among 230 lesions, histopathologic findings showed 34 high-risk breast lesions and 29 DCIS, which were compared with 167 ductal invasive carcinomas. High-risk lesions had lower values of all sonoelastographic features than ductal and invasive carcinoma, however, only E-ratio showed a statistically significant difference in comparison to DCIS (3.7 . 6, p<0.001). All sonoelastographic features showed significant difference between and invasive carcinoma. There was a significant correlation between lesion size and stiffness (r=0.36; p<0.001). Stiffness measured by SWE is an effective predictor of the histopathologic severity of sonographically detectable breast lesions. Elasticity values of high-risk lesions are significantly lower than those of malignant lesions. Furthermore, we showed that along with the sonographic appearance, which in most cases shows typical microcalcifications, DCIS had significantly different elasticity parameters than invasive carcinoma.
本研究的目的是评估在高危乳腺病变和导管原位癌(DCIS)的剪切波超声弹性成像(SWE)上记录的定量超声弹性成像值。我们回顾性分析了在四年期间转诊至我科进行乳腺粗针活检的228名女性的组织病理学和SWE数据(定量最大、最小和平均硬度、病变与脂肪比率(E比率)、病变大小)。在230个病变中,组织病理学结果显示34个高危乳腺病变和29个DCIS,将其与167个导管浸润癌进行比较。高危病变的所有超声弹性成像特征值均低于导管癌和浸润癌,然而,与DCIS相比,只有E比率显示出统计学上的显著差异(3.7对6,p<0.001)。所有超声弹性成像特征在导管癌和浸润癌之间均显示出显著差异。病变大小与硬度之间存在显著相关性(r=0.36;p<0.001)。通过SWE测量的硬度是超声可检测乳腺病变组织病理学严重程度的有效预测指标。高危病变的弹性值显著低于恶性病变。此外,我们还表明,除了在大多数情况下显示典型微钙化的超声表现外,DCIS的弹性参数与浸润癌有显著差异。