中华医学超声杂志（电子版）
中華醫學超聲雜誌（電子版）
중화의학초성잡지（전자판）
CHINESE JOURNAL OF MEDICAL ULTRASOUND(ELECTRONICAL VISION)
2014年
9期
755-758
,共4页
非肿块型乳腺病变%弹性成像%超声检查
非腫塊型乳腺病變%彈性成像%超聲檢查
비종괴형유선병변%탄성성상%초성검사
Non-mass-like breast lesions%Elastography%Ultrasonography
目的：应用剪切波弹性成像技术定量测量乳腺非肿块型病变的弹性模量值，评价该技术在乳腺非肿块型病变诊断中的价值。方法2008年5月至2011年10月，在解放军总医院超声诊断科行超声检查并经手术或穿刺活检病理证实的非肿块型病变80例。对80个乳腺非肿块型病变进行实时剪切波弹性成像检查，获得乳腺病灶的弹性模量参数，分析比较乳腺良恶性非肿块型病变剪切波弹性参数的差异，确定弹性模量在乳腺非肿块型病变诊断中的准确性、敏感度和特异度。结果80个乳腺非肿块型病变中，病理诊断恶性37例（46%），良性43例（54%），恶性非肿块型病变的最大、平均弹性模量值分别为（106.28±46.39）kPa和（51.02±30.06）kPa；良性非肿块型病变的最大、平均弹性模量值分别为（37.13±18.22）kPa和（26.44±15.62）kPa，良恶性病灶间的最大弹性值和平均值差异均有统计学意义（t=15.328、18.149，P均＜0.05）。分别以弹性模量最大值61.25 kPa和平均值40.65 kPa作为诊断阈值时，诊断的准确性、敏感度、特异度分别为70.53%、66.83%、51.22%和68.34%、65.81%、50.63%。将常规超声与弹性模量最大值相结合，则诊断的准确性、敏感度、特异度分别为84.17%、92.28%、68.39%，诊断的准确性和特异度较常规超声相比显著提高（χ2=5.217、9.652，P均＜0.05）。将常规超声与弹性模量平均值相结合，则诊断的准确性、敏感度、特异度分别为82.35%、90.66%、63.35%，诊断的准确性和特异度较常规超声相比显著提高（χ2=5.084、8.686， P均＜0.05）。结论弹性成像单独应用于非肿块型乳腺病变的诊断准确性和特异度并不高，但其与常规超声相结合，可显著提高非肿块型乳腺病变超声诊断的准确性和特异度，具有重要的临床意义。
目的：應用剪切波彈性成像技術定量測量乳腺非腫塊型病變的彈性模量值，評價該技術在乳腺非腫塊型病變診斷中的價值。方法2008年5月至2011年10月，在解放軍總醫院超聲診斷科行超聲檢查併經手術或穿刺活檢病理證實的非腫塊型病變80例。對80箇乳腺非腫塊型病變進行實時剪切波彈性成像檢查，穫得乳腺病竈的彈性模量參數，分析比較乳腺良噁性非腫塊型病變剪切波彈性參數的差異，確定彈性模量在乳腺非腫塊型病變診斷中的準確性、敏感度和特異度。結果80箇乳腺非腫塊型病變中，病理診斷噁性37例（46%），良性43例（54%），噁性非腫塊型病變的最大、平均彈性模量值分彆為（106.28±46.39）kPa和（51.02±30.06）kPa；良性非腫塊型病變的最大、平均彈性模量值分彆為（37.13±18.22）kPa和（26.44±15.62）kPa，良噁性病竈間的最大彈性值和平均值差異均有統計學意義（t=15.328、18.149，P均＜0.05）。分彆以彈性模量最大值61.25 kPa和平均值40.65 kPa作為診斷閾值時，診斷的準確性、敏感度、特異度分彆為70.53%、66.83%、51.22%和68.34%、65.81%、50.63%。將常規超聲與彈性模量最大值相結閤，則診斷的準確性、敏感度、特異度分彆為84.17%、92.28%、68.39%，診斷的準確性和特異度較常規超聲相比顯著提高（χ2=5.217、9.652，P均＜0.05）。將常規超聲與彈性模量平均值相結閤，則診斷的準確性、敏感度、特異度分彆為82.35%、90.66%、63.35%，診斷的準確性和特異度較常規超聲相比顯著提高（χ2=5.084、8.686， P均＜0.05）。結論彈性成像單獨應用于非腫塊型乳腺病變的診斷準確性和特異度併不高，但其與常規超聲相結閤，可顯著提高非腫塊型乳腺病變超聲診斷的準確性和特異度，具有重要的臨床意義。
목적：응용전절파탄성성상기술정량측량유선비종괴형병변적탄성모량치，평개해기술재유선비종괴형병변진단중적개치。방법2008년5월지2011년10월，재해방군총의원초성진단과행초성검사병경수술혹천자활검병리증실적비종괴형병변80례。대80개유선비종괴형병변진행실시전절파탄성성상검사，획득유선병조적탄성모량삼수，분석비교유선량악성비종괴형병변전절파탄성삼수적차이，학정탄성모량재유선비종괴형병변진단중적준학성、민감도화특이도。결과80개유선비종괴형병변중，병리진단악성37례（46%），량성43례（54%），악성비종괴형병변적최대、평균탄성모량치분별위（106.28±46.39）kPa화（51.02±30.06）kPa；량성비종괴형병변적최대、평균탄성모량치분별위（37.13±18.22）kPa화（26.44±15.62）kPa，량악성병조간적최대탄성치화평균치차이균유통계학의의（t=15.328、18.149，P균＜0.05）。분별이탄성모량최대치61.25 kPa화평균치40.65 kPa작위진단역치시，진단적준학성、민감도、특이도분별위70.53%、66.83%、51.22%화68.34%、65.81%、50.63%。장상규초성여탄성모량최대치상결합，칙진단적준학성、민감도、특이도분별위84.17%、92.28%、68.39%，진단적준학성화특이도교상규초성상비현저제고（χ2=5.217、9.652，P균＜0.05）。장상규초성여탄성모량평균치상결합，칙진단적준학성、민감도、특이도분별위82.35%、90.66%、63.35%，진단적준학성화특이도교상규초성상비현저제고（χ2=5.084、8.686， P균＜0.05）。결론탄성성상단독응용우비종괴형유선병변적진단준학성화특이도병불고，단기여상규초성상결합，가현저제고비종괴형유선병변초성진단적준학성화특이도，구유중요적림상의의。
Objective To obtain the elasticity value of non-mass-like breast lesions with supersonic shear wave elastrography (SWE), in order to observe the value of quantitative elastography with SWE in differential diagnosis of non-mass-like breast lesions. Methods SWE was performed in 80 non-mass-like breast lesions. Taking pathologic results as reference, quantitative elasticity value of the lesions were performed. The diagnostic accuracy, sensitivity and speciifcity were calculated. Results In the 80 non-mass-like breast lesions, 37 lesions (46%) were malignant and 43 lesions (54%) were benign. The max and mean elasticity value of malignant lesions were (106.28±46.39) kPa and (51.02±30.06) kPa, and the max and mean elasticity value of benign lesions were (37.13±18.22) kPa and (26.44±15.62) kPa. There was statistical differences between malignant and benign lesions in max and mean elasticity values (t=15.328, 18.149, both P<0.05). Taking 61.25 kPa as the threshold of max elasticity value and 40.65 kPa as the threshold of mean elasticity value, the diagnostic accuracy, sensitivity and speciifcity were 70.53%, 66.83%, 51.22%and 68.34%, 65.81%, 50.63%, respectively. When max elasticity was combined with conventional ultrasound (US), the diagnostic accuracy, sensitivity and speciifcity were 84.17%, 92.28%and 68.39%, respectively. The diagnostic accuracy and speciifcity signiifcantly increased compared with conventional US (χ2=5.217, 9.652, both P<0.05). When mean elasticity was combined with conventional US, the diagnostic accuracy, sensitivity and speciifcity were 82.35%, 90.66%, and 63.35%, respectively. The diagnostic accuracy and speciifcity signiifcantly increased compared with conventional US (χ2=5.084, 8.686, both P<0.05). Conclusions The diagnostic accuracy and speciifcity of SWE for non-mass-like breast lesions are not high. But when SWE is combined with conventional US, the diagnostic accuracy and speciifcity increase signiifcantly, which is very helpful for the diagnostic of non-mass-like breast lesions.
