Department of Transplantation and General Surgery, The First Hospital of China Medical University, Shenyang, China.
Department of Ultrasound, The First Hospital of China Medical University, Shenyang, China.
Medicine (Baltimore). 2024 Jun 7;103(23):e38425. doi: 10.1097/MD.0000000000038425.
Not all the breast lesions were mass-like, some were non-mass-like at ultrasonography. In these lesions, conventional ultrasonography had a high sensitivity but a low specificity. Sonoelastography can evaluate tissue stiffness to differentiate malignant masses from benign ones. Then what about the non-mass lesions? The aim of this study was to evaluate the current accuracy of sonoelastography in the breast non-mass lesions and compare the results with those of the American College of Radiology breast Imaging-Reporting and Data System (BI-RADS).
An independent literature search of English medical databases, including PubMed, Web of Science, Embase & MEDLINE (Embase.com) and Cochrane Library, was performed by 2 researchers. The accuracy of sonoelastography was calculated and compared with those of BI-RADS.
Fourteen relevant studies including 1058 breast non-mass lesions were included. Sonoelastography showed a pooled sensitivity of 0.74 (95% CI: 0.70-0.78), specificity of 0.89 (95% CI: 0.85-0.91), diagnostic odds ratio (DOR) of 25.22 (95% CI: 17.71-35.92), and an area under the curve of 0.9042. Eight articles included both sonoelastography and BI-RADS. The pooled sensitivity, specificity, DOR and AUC were 0.69 versus 0.91 (P < .01), 0.90 versus 0.68 (P < .01), 19.65 versus 29.34 (P > .05), and 0.8685 versus 0.9327 (P > .05), respectively.
Sonoelastography has a higher specificity and a lower sensitivity for differential diagnosis between malignant and benign breast non-mass lesions compared with BI-RADS, although there were no differences in AUC between them.
并非所有的乳腺病变都是肿块样的，有些在超声检查中是非肿块样的。在这些病变中，常规超声具有很高的敏感性，但特异性较低。超声弹性成像可以评估组织的硬度，从而区分恶性肿块和良性肿块。那么非肿块病变呢？本研究旨在评估超声弹性成像在乳腺非肿块病变中的当前准确性，并将结果与美国放射学院乳腺成像报告和数据系统（BI-RADS）进行比较。
由 2 名研究人员独立检索英文医学数据库，包括 PubMed、Web of Science、Embase & MEDLINE（Embase.com）和 Cochrane Library。计算超声弹性成像的准确性，并与 BI-RADS 进行比较。
共纳入 14 项相关研究，包括 1058 例乳腺非肿块病变。超声弹性成像的敏感性为 0.74（95%CI：0.70-0.78），特异性为 0.89（95%CI：0.85-0.91），诊断比值比（DOR）为 25.22（95%CI：17.71-35.92），曲线下面积（AUC）为 0.9042。有 8 篇文章同时包含超声弹性成像和 BI-RADS。超声弹性成像的敏感性、特异性、DOR 和 AUC 分别为 0.69 与 0.91（P<0.01）、0.90 与 0.68（P<0.01）、19.65 与 29.34（P>0.05）、0.8685 与 0.9327（P>0.05）。
与 BI-RADS 相比，超声弹性成像对乳腺非肿块良恶性病变的鉴别诊断具有更高的特异性和较低的敏感性，但 AUC 无差异。
