Department of Radiology, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey.
Clinic of Radiology, Kemalpaşa State Hospital, İzmir, Turkey.
Diagn Interv Radiol. 2023 Sep 5;29(5):674-681. doi: 10.4274/dir.2022.221615. Epub 2022 Dec 23.
Simple fibroadenomas (SFAs), complex fibroadenomas (CFAs), and cellular fibroadenomas (CeFAs) are variants of fibroadenomas. Additionally, some degenerative, hyperplastic, and metaplastic changes may occur in fibroadenomas, forming complicated fibroadenomas. Distinctive ultrasonography (US) features in variants of fibroadenomas and complicated fibroadenomas have not been reported. Shear-wave elastography (SWE) can be applied to effectively discriminate between these variants and complicated fibroadenomas. In this study, we aimed to evaluate SWE findings to discriminate between SFAs and other variants.
In total, 48 patients (26 with SFAs, 16 with CFAs, 3 with CeFAs, and 3 with complicated fibroadenomas) participated in this study. The lesions were classified into two groups according to histopathologic diagnoses. The SWE evaluation and lesion elasticity scores (E, E, and E) were both assessed in m/s and k/Pa, respectively. Two observers measured E, E, and E. Brightness (B)-mode US findings based on the Breast Imaging Reporting and Data System categorization and elasticity scores were recorded. In the statistical analyses, the chi-square test and non-parametric tests were performed. Fisher's exact test was used to compare independent groups, and Spearman's correlation coefficients were used to correlate the SWE data between the two observers. Additionally, receiver operating characteristic curves were analyzed to evaluate the diagnostic performance of the elasticity values.
The B-mode US features in both groups showed no statistical significance. The set of SWE values of both observers demonstrated strong statistical significance in discriminating between group 1 (SFAs) and Group 2 (CFAs, CeFAs, and complicated fibroadenomas).
As the fibroadenoma variants and complicated fibroadenomas have similar US findings, SWE in addition to a conventional B-mode examination can increase the diagnostic performance to discriminate SFAs from other complex and complicated forms of fibroadenomas.
单纯型纤维腺瘤（SFAs）、复杂型纤维腺瘤（CFAs）和细胞型纤维腺瘤（CeFAs）均为纤维腺瘤的变体。此外，纤维腺瘤中可能发生一些退行性、增生性和化生性改变，形成复杂型纤维腺瘤。纤维腺瘤变体和复杂型纤维腺瘤的独特超声（US）特征尚未报道。剪切波弹性成像（SWE）可用于有效区分这些变体和复杂型纤维腺瘤。本研究旨在评估 SWE 结果以区分 SFAs 和其他变体。
共纳入 48 例患者（26 例 SFAs、16 例 CFAs、3 例 CeFAs 和 3 例复杂型纤维腺瘤）参与本研究。根据组织病理学诊断将病变分为两组。以 m/s 和 k/Pa 分别评估 SWE 评估和病变弹性评分（E、Emean 和 Emax）。两位观察者测量 E、Emean 和 Emax。记录基于乳腺影像报告和数据系统（BI-RADS）分类的 B 型超声（B-US）发现和弹性评分。在统计分析中，进行了卡方检验和非参数检验。Fisher 确切检验用于比较独立组，Spearman 相关系数用于分析两位观察者之间的 SWE 数据相关性。此外，还分析了受试者工作特征曲线以评估弹性值的诊断性能。
两组的 B 型 US 特征均无统计学意义。两位观察者的 SWE 值集合在区分组 1（SFAs）和组 2（CFAs、CeFAs 和复杂型纤维腺瘤）方面具有统计学意义。
由于纤维腺瘤变体和复杂型纤维腺瘤的 US 表现相似，因此除了常规 B 型检查外，SWE 还可以提高诊断性能，以区分 SFAs 与其他复杂和复杂形式的纤维腺瘤。
