Wang Yun, Liu Yubo, Zheng Xueyi, Huang Yini, Han Jing, Li Fei, Mao Rushuang, Li Qian, Cao Longhui, Zhou Jianhua
Department of Ultrasound, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.
Department of Ultrasound, Affiliated Tumor Hospital of Zhengzhou University, Zhengzhou, Henan, China.
Clin Breast Cancer. 2020 Jun;20(3):e366-e372. doi: 10.1016/j.clbc.2019.11.002. Epub 2019 Nov 14.
The purpose of this study was to compare the diagnostic performance of ultrasonography (US) and mammography in the differential diagnosis of breast lesions after adding different types of elastography to US.
This institutional review board-approved study included 316 breast lesions in 289 women between July 2016 and July 2018. All these lesions were evaluated with conventional US, elastography, and mammography before biopsy or surgery. Elastography, including elasticity imaging (EI), virtual touch tissue imaging (VTI), and virtual touch imaging quantification (VTIQ), were used to downgrade US Breast Imaging-Reporting and Data System category 4A lesions. Diagnostic performances were calculated for mammography, US elastography, and the combination of US and elastography.
The sensitivity of US (100%) was significantly higher than that of mammography (84.6%; P < .001), but the specificity of US (14.5%) was significantly lower than that of mammography (59.1%; P < .001). After adding EI, VTI, and VTIQ to US, the specificity was significantly increased from 14.5% to 69.4%, 72.6%, and 78.0%, respectively (P < .001), and were significantly higher than that of mammography (P = .043, P = .006, and P < .001, respectively). The sensitivity of US + EI (96.2%) and US + VTI (96.2%) was lower than that of US alone, although not significantly (100%; P = .063 and P = .063, respectively).
The addition of different types of elastography to US improved the diagnostic performance in the differential diagnosis of breast lesions when compared with mammography.
本研究旨在比较超声(US)联合不同类型弹性成像与乳腺X线摄影在乳腺病变鉴别诊断中的诊断性能。
本研究经机构审查委员会批准,纳入了2016年7月至2018年7月期间289名女性的316个乳腺病变。所有这些病变在活检或手术前均接受了传统超声、弹性成像和乳腺X线摄影评估。弹性成像包括弹性成像(EI)、虚拟触诊组织成像(VTI)和虚拟触诊成像定量(VTIQ),用于降低美国放射学会乳腺影像报告和数据系统4A类病变的级别。计算乳腺X线摄影、超声弹性成像以及超声与弹性成像联合检查的诊断性能。
超声的敏感性(100%)显著高于乳腺X线摄影(84.6%;P <.001),但超声的特异性(14.5%)显著低于乳腺X线摄影(59.1%;P <.001)。在超声中加入EI、VTI和VTIQ后,特异性分别从14.5%显著提高到69.4%、72.6%和78.0%(P <.001),且显著高于乳腺X线摄影(分别为P =.043、P =.006和P <.001)。超声 + EI(96.2%)和超声 + VTI(96.2%)的敏感性低于单独超声检查,尽管差异无统计学意义(100%;分别为P =.063和P =.063)。
与乳腺X线摄影相比,超声联合不同类型弹性成像可提高乳腺病变鉴别诊断的诊断性能。