Liu Jian, Wu Jing Ping, Wang Ning, Li Guang Han, Wang Xiu Hong, Wang Ying, Zheng Min, Zhang Bo
Department of Ultrasound, China-Japan Friendship Hospital,Beijing 100029,China.
Second Department of General Surgery,China-Japan Friendship Hospital,Beijing 100029,China.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2021 Feb 28;43(1):63-68. doi: 10.3881/j.issn.1000-503X.12839.
Objective To explore the value of elastography strain ratio(SR)combined with breast ultrasound imaging reporting and data system(BI-RADS-US)in the differential diagnosis of breast nodules.Methods A total of 471 breast nodules(from 471 patients)were reclassified by SR combined with BI-RADS-US.With the pathology results as gold standard,the area under the receiver operating characteristic(ROC)curve(AUC)was employed to evaluate the diagnostic performance,and the sensitivity,specificity,and accuracy were compared between the combined method and BI-RADS-US.Results Among the 471 breast nodules,180 nodules were benign and 291 were malignant.The AUC of the combined method was statistically significantly higher than that of BI-RADS-US(0.798 vs. 0.730;Z= 2.583, P= 0.010).SR,BI-RADS-US,and the combined method for diagnosing breast nodules had the sensitivity of 86.6%,99.0%,and 96.6%,the specificity of 67.2%,47.2%,and 63.3%,and the accuracy of 79.2%,79.2%,and 83.9%,respectively.The combined method increased the specificity from 47.2%(BI-RADS-US)to 63.3%(χ =14.25,P < 0.001),and downgraded 57.5%(42/73)benign nodules of BI-RADS category 4A to category 3.Conclusions SR combined with BI-RADS-US can improve the diagnostic performance for breast nodules.Especially,it can improve the specificity,avoiding unnecessary biopsy of breast nodules.
目的 探讨弹性成像应变率(SR)联合乳腺超声影像报告和数据系统(BI-RADS-US)在乳腺结节鉴别诊断中的价值。方法 采用SR联合BI-RADS-US对471例患者的471个乳腺结节进行重新分类。以病理结果为金标准,采用受试者操作特征(ROC)曲线下面积(AUC)评估诊断性能,并比较联合方法与BI-RADS-US的敏感性、特异性和准确性。结果 471个乳腺结节中,良性结节180个,恶性结节291个。联合方法的AUC显著高于BI-RADS-US(0.798比0.730;Z = 2.583,P = 0.010)。SR、BI-RADS-US及联合方法诊断乳腺结节的敏感性分别为86.6%、99.0%和96.6%,特异性分别为67.2%、47.2%和63.3%,准确性分别为79.2%、79.2%和83.9%。联合方法使特异性从47.2%(BI-RADS-US)提高到63.3%(χ = 14.25,P < 0.001),并将BI-RADS 4A类的57.5%(42/73)良性结节降级为3类。结论 SR联合BI-RADS-US可提高乳腺结节的诊断性能。特别是,它可以提高特异性,避免不必要的乳腺结节活检。