From the Department of Radiology.
From the Department of Clinical Pathology, Institute of Nuclear Medicine and Oncology, Lahore, Punjab, Pakistan.
Ann Saudi Med. 2022 Sep-Oct;42(5):319-326. doi: 10.5144/0256-4947.2022.319. Epub 2022 Oct 6.
Conventional B-mode breast ultrasonography, though the primary modality to determine benign or malignant nature of a solid breast lesion, sometimes encounters overlapping sonographic morphological features in a single lesion. Elastography leads to improvement by evaluating the structural aspects and characterization of the lesion as benign or malignant on the basis of multi-parametric assessment.
Determine the role of strain elastography (SE) and shear wave elastography (SWE) in differentiating benign and malignant breast lesions.
Cross sectional SETTING: Radiology department of hospital PATIENTS AND METHODS: Patients meeting inclusion criteria referred to our hospital for ultrasonography followed by biopsy or surgical excisions were examined with B-mode ultrasonography and by both strain and shear wave elastography.
Mean values of SE and SWE in benign and malignant breast lesions, determination of cutoff using AUC curves and sensitivity and specificity of both techniques.
One hundred breast lesions from 95 consecutive patients.
The mean (SD) strain elastography ratio in the overall patient population was 4.1 (2.0). Cutoff for benign vs. malignant lesions was 2.86 on the ROC curve. The AUC was 0.911 (95%CI; 0.835-0.988: SE, 0.039) with a sensitivity of 95.8% and a specificity of 89.3%. For the SWE kPa values, the ROC curve showed the AUC was 0.929 (95% CI, 0.870-0.988; SE: 0.030, <.001). Assigning 45.3 as a cut off value provided a sensitivity of 95.8% with a specificity of 85.7%; the positive predictive value was 94.5% and the negative predictive value was 89.6%. The Breast Imaging Reporting and Data System (BI-RADS) category alone was able to differentiate between benign and malignant lesions with a sensitivity of 91.7% and a specificity 100% keeping the cut off value between 4a and 4b. The area under the ROC curve was 0.979. Combining the three (BI-RADS + SE + SWE) distinguished benign vs. malignant lesions with a sensitivity up to 100% and specificity up to 96.3%.
Combining SE and SWE as a complementary tool with conventional B-mode ultrasonography has a significant potential for better characterization of solid breast lesions and decreasing unnecessary biopsies of BI-RADS IVa lesions.
Single institution study.
None.
虽然常规 B 型超声是确定实性乳腺病变良恶性的主要方法，但有时在单个病变中会出现重叠的超声形态特征。弹性成像是通过评估病变的结构特征和多参数评估来判断病变的良恶性，从而提高诊断能力。
探讨应变弹性成像（SE）和剪切波弹性成像（SWE）在鉴别乳腺良恶性病变中的作用。
回顾性研究
医院放射科
符合纳入标准的患者，在我院行超声检查后行活检或手术切除，对其进行 B 型超声检查、SE 和 SWE 检查。
乳腺良恶性病变的 SE 和 SWE 均值，采用 AUC 曲线确定截断值，以及两种技术的敏感性和特异性。
连续 95 例患者的 100 个乳腺病变。
总的患者人群的 SE 比值的平均值（标准差）为 4.1（2.0）。ROC 曲线的良性与恶性病变的截断值为 2.86。AUC 为 0.911（95%CI；0.835-0.988：SE，0.039），敏感性为 95.8%，特异性为 89.3%。对于 SWE kPa 值，ROC 曲线的 AUC 为 0.929（95%CI，0.870-0.988；SE：0.030，<.001）。将 45.3 作为截断值，敏感性为 95.8%，特异性为 85.7%；阳性预测值为 94.5%，阴性预测值为 89.6%。单独使用乳腺影像报告和数据系统（BI-RADS）类别能够区分良性和恶性病变，其敏感性为 91.7%，特异性为 100%，将截断值保持在 4a 和 4b 之间。ROC 曲线下面积为 0.979。将 BI-RADS+SE+SWE 三种方法相结合，可以提高诊断的敏感性（高达 100%）和特异性（高达 96.3%），从而更好地区分良性和恶性病变。
将 SE 和 SWE 作为常规 B 型超声的补充工具，对实性乳腺病变的特征具有重要的潜在作用，并可减少 BI-RADS IVa 病变的不必要活检。
单中心研究。
无。
