Yıldız Mehmet Sıddık, Goya Cemil, Adin Mehmet Emin
Batman Dunya Hospital, Batman, Turkey.
Van Yüzüncü Yıl University Faculty of Medicine, Van, Turkey.
J Ultrasound Med. 2020 Jul;39(7):1395-1403. doi: 10.1002/jum.15236. Epub 2020 Feb 21.
The purpose of this study was to investigate the contribution of strain index measurements and a 5-point scoring method to diagnostic accuracy in differential diagnosis of benign and malignant solid breast masses and to compare the diagnostic performances of both methods.
Eighty female patients were included in this study. Before biopsy, all patients underwent ultrasound (US) and sonoelastographic examinations. The elastographic images of lesions were assessed according to the 5-point scoring method, and then elasticity scores were determined. Strain values of the masses and subcutaneous adipose tissue were measured. The diagnostic efficacies of B-mode US, sonoelastographic 5-point scoring, and strain index methods were compared with histopathologic findings.
The mean age of the patients ± SD was 42 ± 13 years (range, 14-81 years). In histopathologic evaluations, 59 (74%) lesions were diagnosed as benign, and 21 (26%) were diagnosed as malignant. The mean strain index values were 10.45 ± 7.04 (range, 3.4-25.1) in malignant lesions and 2.88 ± 2.5 (range, 0.5-19.81) in benign lesions. The mean strain index for malignant lesions was significantly higher than that for benign lesions (P < .05). The highest sensitivity was found for B-mode US, and the highest specificity was found for the strain index. The diagnostic performance of the strain index was higher than that of the 5-point scoring method.
The addition of a sonoelastographic examination to B-mode US prevents unnecessary biopsies. The strain index was found to be superior to the 5-point scoring method to a limited extent.
本研究旨在探讨应变指数测量和5分评分法对乳腺实性良恶性肿块鉴别诊断准确性的贡献，并比较这两种方法的诊断性能。
本研究纳入了80例女性患者。在活检前，所有患者均接受了超声（US）和超声弹性成像检查。根据5分评分法对病变的弹性成像图像进行评估，然后确定弹性评分。测量肿块和皮下脂肪组织的应变值。将B型超声、超声弹性成像5分评分法和应变指数法的诊断效能与组织病理学结果进行比较。
患者的平均年龄±标准差为42±13岁（范围14 - 81岁）。在组织病理学评估中，59个（74%）病变被诊断为良性，21个（26%）被诊断为恶性。恶性病变的平均应变指数值为10.45±7.04（范围3.4 - 25.1），良性病变为2.88±2.5（范围0.5 - 19.81）。恶性病变的平均应变指数显著高于良性病变（P <.05）。B型超声的敏感性最高，应变指数的特异性最高。应变指数的诊断性能高于5分评分法。
在B型超声检查中增加超声弹性成像检查可避免不必要的活检。应变指数在一定程度上优于5分评分法。
