Sinha Dimpi, Sharma Sukrity, Kundaragi Nischal G, Kale Sudhir Kumar
Department of Radio Diagnosis, Aster CMI Hospital, Bengaluru, India.
Department of Interventional Radiology, Aster CMI Hospital, Bengaluru, India.
Ultrasound. 2020 Aug;28(3):164-173. doi: 10.1177/1742271X20912762. Epub 2020 Mar 16.
Elastography is a new promising ultrasonographic technique which is used to differentiate benign and malignant breast lesions based on the stiffness of the lesion.
To determine the role of strain elastography in characterisation of breast lesions and to compare the diagnostic performances of strain elastography and conventional ultrasound (US).
In total, 113 breast lesions in 100 women were prospectively evaluated by US and strain elastography followed by the histopathological examination. Elastography score based on the Tsukuba colour scale and strain ratio were determined for each lesion. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value were calculated for each modality and the diagnostic performances were compared. The best cut-off point was calculated for each of the elastography parameters using the receiver operator curve analysis.
Out of the 113 lesions, 40 were malignant (35.4%) and 73 were benign (64.6%). The area under the curve for elastography score showed significant difference with that of US: 0.98 versus 0.90 (Difference = 0.08, =0.02). The elastography parameters were more specific as compared to US (ES-95 and SR-93% vs. 63%, < 0.05) with a high negative predictive value. The combined use of elastography and US gave better results with 95% sensitivity, 94% specificity, 94% accuracy and negative predictive value reaching 97%.
Strain elastography is a useful adjunct to conventional ultrasonography. The combined use of strain elastography and ultrasound improves the characterisation of breast lesions and helps in down-staging of assigned BI-RADS category, thereby avoiding unnecessary biopsies. ES is the most useful elastography parameter to differentiate between benign and malignant breast lesions.
弹性成像技术是一种新兴且有前景的超声技术，用于根据病变的硬度来鉴别乳腺良恶性病变。
确定应变弹性成像在乳腺病变特征描述中的作用，并比较应变弹性成像与传统超声（US）的诊断性能。
前瞻性地对100名女性的113个乳腺病变进行超声和应变弹性成像检查，随后进行组织病理学检查。为每个病变确定基于筑波彩色量表的弹性成像评分和应变比。计算每种检查方法的敏感性、特异性、准确性、阳性预测值和阴性预测值，并比较诊断性能。使用受试者操作特征曲线分析为每个弹性成像参数计算最佳截断点。
113个病变中，40个为恶性（35.4%），73个为良性（64.6%）。弹性成像评分的曲线下面积与超声的曲线下面积有显著差异：0.98对0.90（差异=0.08，P=0.02）。与超声相比，弹性成像参数更具特异性（弹性成像评分-95%和应变比-93%对63%，P<0.05），阴性预测值较高。弹性成像和超声联合使用效果更好，敏感性为95%，特异性为94%，准确性为94%，阴性预测值达97%。
应变弹性成像是传统超声检查的有用辅助手段。应变弹性成像与超声联合使用可改善乳腺病变的特征描述，并有助于降低指定的乳腺影像报告和数据系统（BI-RADS）分类，从而避免不必要的活检。弹性成像评分是鉴别乳腺良恶性病变最有用的弹性成像参数。
