两种不同系统的二维剪切波弹性成像在乳腺病变诊断中的应用。
Two-dimensional shear wave elastography with two different systems for the diagnosis of breast lesions.
机构信息
Department of Medical Ultrasound, Shanghai Tenth Hospital, School of Clinical Medicine of Nanjing Medical University, Shanghai, P.R. China.
Department of Medical Ultrasound, Center of Minimally Invasive Treatment for Tumor, Shanghai Tenth People's Hospital; Ultrasound Research and Education Institute, Clinical Research Center for Interventional Medicine, School of Medicine, Tongji University. Shanghai, P.R. China.
出版信息
Clin Hemorheol Microcirc. 2022;82(1):53-62. doi: 10.3233/CH-221471.
BACKGROUND
Two-dimensional (2D) - shear wave elastography (SWE) has made promising advances in the diagnostic of breast lesions. However, few studies have assessed whether the diagnostic effectiveness of different platforms employing 2D-SWE is equal or different.
OBJECTIVE
To compare the diagnostic effectiveness of 2D-SWE techniques from two different systems in differentiating malignant breast lesions from benign ones.
METHODS
A total of 84 breast lesions were retrospectively analyzed by experienced radiologists using 2D-SWE on two ultrasound systems, i.e. system-1 (LOGIQ E9 system, GE Healthcare, Wauwatosa, WI, USA), and system-2 (Aixplorer US system, SuperSonic Imagine, Aix-en-Provence, France). Qualitative and quantitative parameters including color sign, the maximum elasticity modulus values (E-max), the mean elasticity modulus values (E-mean) and standard deviation (E-sd) of elasticity modulus values in two 2D-SWE systems were analyzed. The diagnostic performance between system-1 and system-2 were evaluated in terms of the areas under the receiver operating characteristic curves (AUROCs).
RESULTS
Among the 84 lesions in this study, 66 (78.6%) were benign and 18 (21.4%) were malignant. E-max in system-1 showed the best diagnostic performance with a cut-off value of 174.5 kPa with the associated sensitivity and specificity of 100.0% and 80.3% respectively. Meanwhile, E-sd in system-2 displayed the best diagnostic performance with a cut-off value of 12.7 kPa, with the associated sensitivity and specificity of 94.4% and 80.3% respectively. The diagnostic performance of the two 2D-SWE systems was not statistically different according to receiver operating characteristic curve (ROC) analysis of E-max, E-mean, and E-sd.
CONCLUSION
For identifying breast lesions, system-1 and system-2 appear to be similar in diagnostic performance. However, different cut-off values for different parameters might be selected to obtain the best diagnostic performance for the two 2D-SWE systems.
背景
二维（2D）-剪切波弹性成像（SWE）在诊断乳腺病变方面取得了令人瞩目的进展。然而，很少有研究评估不同平台使用 2D-SWE 的诊断效果是否相同或不同。
目的
比较两种不同系统的 2D-SWE 技术在鉴别乳腺良恶性病变方面的诊断效能。
方法
回顾性分析了 84 个乳腺病变，由经验丰富的放射科医生在两种超声系统上使用 2D-SWE 进行检测，即系统 1（LOGIQ E9 系统，GE 医疗，美国威斯康星州沃瓦托萨）和系统 2（Aixplorer US 系统，SuperSonic Imagine，法国艾克斯普罗旺斯）。分析了两种 2D-SWE 系统的定性和定量参数，包括彩色信号、最大弹性模量值（E-max）、平均弹性模量值（E-mean）和弹性模量值标准差（E-sd）。通过受试者工作特征曲线（ROC）下面积（AUROCs）评估系统 1 和系统 2 之间的诊断性能。
结果
本研究中的 84 个病变中，66 个（78.6%）为良性，18 个（21.4%）为恶性。系统 1 中的 E-max 具有最佳的诊断性能，其截断值为 174.5 kPa，对应的灵敏度和特异性分别为 100.0%和 80.3%。同时，系统 2 中的 E-sd 具有最佳的诊断性能，截断值为 12.7 kPa，对应的灵敏度和特异性分别为 94.4%和 80.3%。根据 E-max、E-mean 和 E-sd 的 ROC 分析，两种 2D-SWE 系统的诊断性能无统计学差异。
结论
对于识别乳腺病变，系统 1 和系统 2 的诊断性能似乎相似。然而，不同的参数可能需要选择不同的截断值，以获得两种 2D-SWE 系统的最佳诊断性能。
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