剪切波弹性成像技术在鉴别良恶性乳腺病变中的组织弹性作用。
The role of tissue elasticity in the differential diagnosis of benign and malignant breast lesions using shear wave elastography.
机构信息
Department of Ultrasound in Medicine, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, 310009, China.
Department of Ultrasound Medicine, Laboratory of Ultrasound Molecular Imaging, The Third Affiliated Hospital of Guangzhou Medical University, The Liwan Hospital of the Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510000, Guangdong, China.
出版信息
BMC Cancer. 2020 Sep 29;20(1):930. doi: 10.1186/s12885-020-07423-x.
BACKGROUND
Elastography is a promising way to evaluate tissue differences regarding stiffness, and the stiffness of the malignant breast lesions increased at the lesion margin. However, there is a lack of data on the value of the shear wave elastography (SWE) parameters of the surrounding tissue (shell) of different diameter on the diagnosis of benign and malignant breast lesions. Therefore, the purpose of our study was to evaluate the diagnostic performance of shell elasticity in the diagnosis of benign and malignant breast lesions using SWE.
METHODS
Between September 2016 and June 2017, women with breast lesions underwent both conventional ultrasound (US) and SWE. Elastic values of the lesions peripheral tissue were determined according to the shell size, which was automatically drawn along the edge of the lesion using the following software guidelines: (1): 1 mm; (2): 2 mm; and (3): 3 mm. Quantitative elastographic features of the inner lesions and shell, including the elasticity mean (E), elasticity maximum (E), and elasticity minimum (E), were calculated using an online-available software. The receiver operating characteristic curves (ROCs) of the elastographic features was analyzed to assess the diagnostic performance, and the area under curve (AUC) of each elastographic feature was obtained. Logistic regression analysis was used to predict significant factors of malignancy, permitting the design of predictive models.
RESULTS
This prospective study included 63 breast lesions of 63 women. Of the 63 lesions, 33 were malignant and 30 were benign. The diagnostic performance of E was the highest (AUC = 0.76) with a sensitivity of 60.6% and a specificity of 83.3%. According to stepwise logistic regression analysis, the E and the E were significant predictors of malignancy (p < 0.05). The AUC of the predictive equation was 0.86.
CONCLUSIONS
SWE features, particularly the combination of E and E can improve the diagnosis of breast lesions.
背景
弹性成像是一种有前途的评估组织硬度差异的方法，恶性乳腺病变的硬度在病变边缘增加。然而，关于不同直径的周围组织（壳）的剪切波弹性成像（SWE）参数在良性和恶性乳腺病变诊断中的价值的数据还很缺乏。因此，我们的研究目的是评估 SWE 技术在诊断乳腺良恶性病变中壳弹性的诊断性能。
方法
在 2016 年 9 月至 2017 年 6 月期间，患有乳腺病变的女性同时接受了常规超声（US）和 SWE 检查。弹性值根据壳的大小确定，壳是通过使用以下软件指南沿着病变的边缘自动绘制的：（1）1mm；（2）2mm；和（3）3mm。使用在线可用的软件计算病变内组织和壳的定量弹性特征，包括弹性平均值（E）、弹性最大值（E）和弹性最小值（E）。分析弹性特征的受试者工作特征曲线（ROC）以评估诊断性能，并获得每个弹性特征的曲线下面积（AUC）。使用逻辑回归分析预测恶性肿瘤的显著因素，允许设计预测模型。
结果
这项前瞻性研究包括 63 名女性的 63 个乳腺病变。在 63 个病变中，33 个是恶性的，30 个是良性的。E 的诊断性能最高（AUC=0.76），敏感性为 60.6%，特异性为 83.3%。根据逐步逻辑回归分析，E 和 E 是恶性肿瘤的显著预测因素（p<0.05）。预测方程的 AUC 为 0.86。
结论
SWE 特征，特别是 E 和 E 的组合，可以提高乳腺病变的诊断。
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