CAJ | 학술논문

目的探讨剪切波弹性成像(shear wave elastography,SWE)定量测定乳腺实性病变的弹性模量值对乳腺实性病变良恶性诊断的价值.方法对103例女性患者共125个乳腺实性病变行SWE检查,进行乳腺病灶弹性模量定量测定,以手术病理结果为诊断金标准构建ROC曲线,评价SWE定量测值在乳腺实性病灶良恶性诊断方面的价值.结果病理诊断良性66例(87个病灶),恶性37例(38个病灶),恶性病灶的最大弹性模量值中位数、最小弹性模量值中位数、平均弹性模量值中位数分别为192.0(42.7-300.0)kPa、68.1(0.1-192.0)kPa、138.0(23.9-271.1)kPa;良性病灶的最大弹性模量值中位数、最小弹性模量值中位数、平均弹性模量值中位数分别为47.2(7.4-192.0)kPa、22.4(1.8-90.7)kPa、36.3(5.3-124.7)kPa;良恶性病变间的最大弹性模量值、最小弹性模量值、平均弹性模量值间差异均有统计学意义(P＜0.01).乳腺病灶最大弹性模量值、最小弹性模量值与平均弹性模量值对诊断乳腺良恶性病灶的ROC曲线下面积分别为0.935、0.853和0.917(P＜0.01).分别以乳腺病灶最大弹性模量值87.65 kPa、最小弹性模量值37.15 kPa和平均弹性模量值66.85 kPa为诊断界值时,诊断良恶性病变的敏感度、特异度分别为91.4％、88.5％,80.0％、83.9％和85.7％、88.5％.结论 SWE可以定量测定乳腺肿物的硬度,病灶的弹性模量值可为判断乳腺实性病灶良恶性提供诊断依据.
목적 탐토전절파탄성성상(shear wave elastography,SWE)정량측정유선실성병변적탄성모량치대유선실성병변량악성진단적개치.방법 대103례녀성환자공125개유선실성병변행SWE검사,진행유선병조탄성모량정량측정,이수술병리결과위진단금표준구건ROC곡선,평개SWE정량측치재유선실성병조량악성진단방면적개치.결과 병리진단량성66례(87개병조),악성37례(38개병조),악성병조적최대탄성모량치중위수、최소탄성모량치중위수、평균탄성모량치중위수분별위192.0(42.7-300.0)kPa、68.1(0.1-192.0)kPa、138.0(23.9-271.1)kPa;량성병조적최대탄성모량치중위수、최소탄성모량치중위수、평균탄성모량치중위수분별위47.2(7.4-192.0)kPa、22.4(1.8-90.7)kPa、36.3(5.3-124.7)kPa;량악성병변간적최대탄성모량치、최소탄성모량치、평균탄성모량치간차이균유통계학의의(P＜0.01).유선병조최대탄성모량치、최소탄성모량치여평균탄성모량치대진단유선량악성병조적ROC곡선하면적분별위0.935、0.853화0.917(P＜0.01).분별이유선병조최대탄성모량치87.65 kPa、최소탄성모량치37.15 kPa화평균탄성모량치66.85 kPa위진단계치시,진단량악성병변적민감도、특이도분별위91.4％、88.5％,80.0％、83.9％화85.7％、88.5％.결론 SWE가이정량측정유선종물적경도,병조적탄성모량치가위판단유선실성병조량악성제공진단의거.
Objective To obtain the elasticity value of benign and malignant breast solid lesion with real-time shear wave elastography (SWE),in order to assess the value of quantitative elastography with SWE in diagnosis of benign and malignant breast solid lesions.Methods From June 2012 to November 2012,SWE was performed in 125 breast lesions of 103 female patients with pathologically confirmed results,to obtain the elastic modulus (mean,maximum,minimum).Taking pathologic results as reference,ROC curves were used to assess diagnostic performance.Results 87 lesions of 66 patients were pathologically confirmed benign whereas 38 lesions of 37 patients were malignant.The maximum,mean,and minimum elasticity value of benign lesions was 47.2 (7.4-192.0) kPa,22.4 (1.8-90.7) kPa,36.3 (5.3-124.7)kPa; whereas of malignant ones was 192.0(42.7-300.0)kPa,68.1 (0.1-192.0)kPa,138.0(23.9-271.1)kPa.The maximum,minimum and mean elasticity value between benign and malignant lesions had statistically significant difference(P ＜0.01).The area under the ROC curve of the maximum,minimum and mean elasticity value was 0.935,0.853 and 0.917(P ＜0.01).Taking 87.65 kPa as the threshold of the maximum elasticity value,the sensitivity was 91.4％ and the specificity was 88.5％.Taking 37.15 kPa as the threshold of the minimum elasticity value,the sensitivity was 80.0％ and the specificity was 83.9％.Taking 66.85 kPa as the threshold of the mean elasticity value,the sensitivity was 85.7％ and the specificity was 88.5％.Conclusions SWE can assess the stiffness of the breast solid neoplasm by quantitatively measuring the elastic modulus,thus providing diagnostic basis in differential diagnosis of breast lesions.SWE elastic modulus value measurement for breast solid lesions provides a new effective and objective diagnostic method.