应变比值评价常规超声分级BI-RADS4级乳腺病灶良恶性的应用研究

摘要

Objective To assessment the value of strain ratio(SR) in differentiating benign and malignant breast lesions of BI-RADS Ⅳ diagnosed by conventional ultrasound.Methods Elastosonography was performed on 64 patients with breast lesions of BI-RADS Ⅳ diagnosed by conventional ultrasound.SR (strainnormal neighboring tissues /strainbreast lesion) was calculated by the software equipped with the ultrasonic machine.Pathology of the lesions after biopsy or operation was considered as standard,SRs of benign and malignant breast lesions were compared with independent-samples t test.The diagnostic value of SR was evaluated by receiver operating characteristic (ROC) curve analysis.Results SRs of 34 benign breast lesions and 30 malignant breast lesions were 2.85 ± 1.30 and 5.03 ± 2.50 respectively,there was significant difference between them( t =- 4.29,P =0.000).Area under the curve of diagnosing benign and malignant of breast lesions was 0.875 for SR( P ＜0.0001).If the cut-off point of SR was 3.26,the sensitivity in differentiating breast lesions was 83.33％,while the specificity was 82.35％.Conclusions SR is a helpful elasticity parameter for differentiating benign and malignant breast lesions of BI-RADS Ⅳ diagnosed by conventional ultrasound.%目的 探讨周围组织与乳腺病灶的应变比值( strain ratio,SR)鉴别常规超声分级为BI-RADS 4级乳腺病灶良恶性的应用价值.方法 64例(良性34例,恶性30例)常规超声诊断为BI-RADS 4级乳腺病灶,通过超声弹性成像获得周围组织与乳腺病灶的SR,以穿刺活检或手术病理结果为标准,分析良、恶性病灶SR之间的差异,应用ROC曲线评价SR鉴别乳腺可疑恶性病变的价值.结果 34例良性乳腺病灶及30例恶性乳腺病灶的SR值分别为2.85±1.30及5.03±2.50,两者间差异有统计学意义(t=-4.29,P=0.000).应用SR鉴别常规超声分级为BI-RADS 4级乳腺病灶的良恶性,ROC曲线下面积为0.875(P ＜0.0001).当SR诊断阈值取3.26时,鉴别常规超声分级为BI-RADS 4级乳腺病灶良恶性的敏感性为83.33％,特异性为82.35％.结论 超声弹性参数SR对常规超声发现的乳腺BI-RADS 4级病灶的鉴别诊断有较好的应用价值.