实时超声弹性成像应变率比值鉴别乳腺肿块性质的价值

摘要

Objective To investigate the clinical value of real-time ultrasound electrography strain ratio ( SR) in the diagnosis of breast tumors of different sizes .Methods Forty patients with breast tumors ( 56 tumors ) had 24 tumors with tumor diameter ≥2.0 cm(group A) and 32 tumors with tumor diameter <2.0 cm(group B),SRs were analyzed and compared between two groups .The receiver operating characteristic ( ROC) curve was established based on the pathology results(gold standard) and SR(result),and the area under the curve(AUC) was calculated.Results ROC curve showed AUC value was 0.846,and the critical value of SR was determined to be 3.21 with the maximum Youden index cut-off point of 0.786.The SR of malignant masses was significantly larger than that of benign tumors [(5.2 ±1.2) vs.(2.1 ±0.2),P<0.05)].The SRs of benign masses ranged from 1.04 to 4.66 in group A,of malignant tumors ranged from 1.87 to 11.33.And taking SR of 4.76 as the critical value,AUC value was 0.878.The SR of benign masses ranged from 1.05 to 3.11,of malignant tumors ranged from 1.22 to 8.85.And taking SR of 2.58 as the critical value,AUC value was 0.889.The AUC of group A was significantly smaller than that of group B (P<0.05). Conclusion Real-time electrography strain ratio can be applied to accurate diagnosis of breast tumor for patients with breast tumors of different sizes ,and it′s a simple ,non-invasive method with good reproducibility .%目的：探讨实时弹性成像应变率比值（ SR ）对不同大小乳腺肿块的诊断价值。方法乳腺肿块患者40例（56枚肿块），其中肿块直径≥2．0 cm有24枚（A组），肿块直径＜2．0 cm有32枚（B组），对比并分析2组SR；以病理检查结果为“金标准”，SR为结果，建立工作特征曲线（ROC），计算曲线下面积（AUC）。结果 ROC曲线图显示AUC为0．846，选择约登指数最大值0．786为临界点，确定SR临界值为3．21。恶性肿块的SR为（5．2±1．2），明显大于良性肿块的（2．1±0．2）（P＜0．05）。 A组良性肿块SR为1．04～4．66，恶性肿块SR值为1．87～11．33；将SR为4．76作为临界值，AUC为0．878。 B组良性肿块SR为1．05～3．11，恶性肿块SR为1．22～8．85；将SR为2．58作为临界值，AUC为0．889。 A组AUC明显小于B组（P＜0．05）。结论对于不同大小乳腺肿块患者，实时超声弹性成像SR能准确鉴别乳腺肿块性质，操作简单、无创，重复性好。