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弹性成像应变率联合乳腺超声影像报告和数据系统在乳腺结节诊断中的价值

[Value of Elastography Strain Ratio Combined with Breast Ultrasound Imaging Reporting and Data System in the Diagnosis of Breast Nodules].

作者信息

Liu Jian, Wu Jing Ping, Wang Ning, Li Guang Han, Wang Xiu Hong, Wang Ying, Zheng Min, Zhang Bo

机构信息

Department of Ultrasound, China-Japan Friendship Hospital,Beijing 100029,China.

Second Department of General Surgery,China-Japan Friendship Hospital,Beijing 100029,China.

出版信息

Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2021 Feb 28;43(1):63-68. doi: 10.3881/j.issn.1000-503X.12839.

Abstract

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.

摘要

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。

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