CAJ | 학술논문

目的：应用剪切波弹性成像技术检测不同乳腺病灶的弹性模量值，评价其在鉴别乳腺病灶良恶性中的应用价值。方法收集该院经病理确诊的63例患者，共71个病灶。行剪切波弹性成像，检测弹性模量的最大值、最小值和平均值。并行 ROC曲线确定最佳诊断位点。结果71个病灶中良性病灶48个，恶性病灶23个。普通超声对良恶性病变诊断的准确性及 Youden指数分别为77．5％和0．55。恶性病灶剪切波弹性最大值、最小值及平均值分别为（106．7±37．9）、（23．7±6．4）、（44．8±6．6） kPa，良性病灶弹性最大值、最小值及平均值分别为（42．7±14．6）、（17．2±6．3）、（29．4±8．0）kPa。良恶性病灶间弹性最大值、最小值及平均值间差异均有统计学意义（P＜0．05）。弹性最大值、最小值及平均值 ROC曲线下面积（AUC）分别为0．963、0．798、0．914。分别以78．1 kPa及37．6 kPa作为弹性最大值及平均值的诊断位点，其敏感性及特异性分别为82．6％、95．8％及87．0％、83．3％。结论剪切波弹性成像为鉴别乳腺病变的良恶性提供了新的途径。病灶的弹性最大值及平均值可作为鉴别良恶性的依据。
목적：응용전절파탄성성상기술검측불동유선병조적탄성모량치，평개기재감별유선병조량악성중적응용개치。방법수집해원경병리학진적63례환자，공71개병조。행전절파탄성성상，검측탄성모량적최대치、최소치화평균치。병행 ROC곡선학정최가진단위점。결과71개병조중량성병조48개，악성병조23개。보통초성대량악성병변진단적준학성급 Youden지수분별위77．5％화0．55。악성병조전절파탄성최대치、최소치급평균치분별위（106．7±37．9）、（23．7±6．4）、（44．8±6．6） kPa，량성병조탄성최대치、최소치급평균치분별위（42．7±14．6）、（17．2±6．3）、（29．4±8．0）kPa。량악성병조간탄성최대치、최소치급평균치간차이균유통계학의의（P＜0．05）。탄성최대치、최소치급평균치 ROC곡선하면적（AUC）분별위0．963、0．798、0．914。분별이78．1 kPa급37．6 kPa작위탄성최대치급평균치적진단위점，기민감성급특이성분별위82．6％、95．8％급87．0％、83．3％。결론전절파탄성성상위감별유선병변적량악성제공료신적도경。병조적탄성최대치급평균치가작위감별량악성적의거。
Objective To use the real-time shear wave elastography(SWE)to detect the elasticmodulus values of different breast lesions,and to assess its application value in differential diagnosis of benign and malignant breast lesions.Methods SWE was per-formed in 71 breast lesions from 63 pathologically confirmed patients.The maximum,minimum and mean elasticmodulus values in breast lesions were detected and the ROC curves were used to determine the optimal diagnostic cut off value.Results Among 7 1 le-sions,48 cases were benign lesions and 23 cases were malignant lesions.The diagnostic accuracy and Youden index of the ordinary ultrasound were 77.5% and 0.55 respectively.The maximum,minimum and mean elasticity values for malignant lesions were (106.7±37.9),(23.7±6.4),(44.8±6.6)kPa respectively,whereas which for benign lesions were(42.7±14.6),(17.2±6.3), (29.4±8.0)kPa respectively.The maximum,minimum and mean elastic values had statistically significant differences between be-nign and malignant lesions(P<0.05).The areas under the curve(AUC)of the maximum,minimum and mean elastic values were 0.963,0.798 and 0.914 respectively.Taking 78.1 kPa as the threshold of the maximum elasticity value,the sensitivity was 82.6%and the specificity was 95.8%.Taking 37.6 kPa as the threshold of the mean elasticity value,the sensitivity was 87.0% and the specificity was 83.3%.Conclusion SWE provides a new way for the differential diagnosis of benign and malignant breast lesions, and the maximum and mean elastic value can be used as the diagnostic evidence for differentiating benign and malignant breast le-sions.