Objective To investigate the value of Q-analysis real-time elasticity in the differential diagnosis of breast benign and malignant lesions. Methods Ninety-four breast nodules in patients were included in this study and were examined using Q-analysis real-time elasticity. All the nodules were diagnosed as malignant and benign lesions by surgery or biopsy. The receiver operating characteristic (ROC) curves of the whole elasticity rate and local elasticity rate was performed. We compared the areas under ROC curves (AUC) of the two methods and confirmed the best cutoff point of the breast diseases diagnosis as well as these sensitivity and specificity. Lastly,we assessed the ROC curves with Z test to determine whether the significant difference between the two methods. Results There were 22 benign and 72 malignant nodules according to pathological examination. The Q-analysis curve of benign nodules was smoother and with lower peak, while malignant was opposite. The whole elasticity rate of malignant nodules were significantly higher than that of benign nodules(3.59 ± 0.84 vs 2.32 ± 0.56,P =0.000). And the local elasticity rate of malignant nodules was significantly higher than that of benign nodules (3.96 ± 1.32 vs 2.39 ± 0.58,P =0.000). The AUC of the whole and local modality was 0.795 and 0.893( >0.5). Both methods were accurate for the diagnosis of breast disea-ses.The cutoff point of whole elasticity rate for the differential diagnosis was 3.2,with that sensitivity was 86.36% and specificity was 83.33%. The cutoff point of local elasticity rate for the differential diagnosis was 2.6,with that sensitivity was 95.45% and specificity was 90.28%. The difference between the two methods was significant( Z =1.96,P =0.027). Conclusion Q-anal-ysis real-time elasticity could provide the real-time elasticity features of breast nodules and is valuable to distinguish benign and malignant breast lesions. The sensitiveness and specificity of local modality are higher than those of whole modality.%目的 探讨 Q-analysis 实时弹性成像技术在诊断乳腺良恶性病变中的应用价值.方法 选取2016年8月~2017年8月在连云港市第一人民医院行乳腺超声检查的乳腺结节患者79例,共94个结节,所有结节均获得明确病理结果.应用 Q-analysis系统实时组织弹性定量分析,获得乳腺肿块的整体和局部弹性比值,并绘制受试者操作特性(ROC)曲线,分析结节整体及局部弹性比值的曲线下面积,确定诊断的最佳临界值及两种方法评估乳腺肿块良恶性的敏感度及特异度,并应用Z检验分析ROC曲线,比较两种方法在乳腺疾病诊断中的差异是否具有统计学意义.结果 94个病灶中良性肿块72个,恶性肿块22个.弹性图像显示良性结节的 Q-analysis 曲线较平稳,峰值较低;恶性结节曲线波动较大,峰值较高;乳腺恶性肿块与良性肿块的整体弹性比值分别为3.49 ± 1.02、2.40 ± 0.80,二者比较具有统计学意义( P<0.05),恶性肿块与良性肿块的局部弹性比值分别为3.33 ± 0.93、2.13 ± 0.85,两者比较差异有统计学意义( P <0.05);实时弹性分析乳腺病灶整体及局部弹性比率值法的ROC曲线下面积分别为0.795和0.893,两种方法分析比较,对良恶性的乳腺病变的鉴别诊断具有较高的准确性;乳腺病灶整体及局部临界值分别为3.2和2.6,其诊断的敏感度和特异度分别为86.36%、83.33%和95.45%、90.28%;两种方法对乳腺良恶性诊断效能的比较差异有统计学意义( Z =1.96,P =0.027).结论 Q-analysis实时弹性分析技术可评估病灶的动态的实时的弹性图像征象,为乳腺病变良恶性的鉴别诊断提供依据,而且局部弹性比率值的敏感性及特异度优于整体弹性比率值.
展开▼
