乳腺良恶性病变剪切波弹性成像的典型表现及其鉴别诊断价值

目的:观察乳腺良恶性病变的剪切波弹性成像(SWE)的典型表现,探讨SWE对乳腺良恶性病变的鉴别诊断价值。方法:选取2017年6月～2019年6月我院收治的162例行SWE检查的乳腺肿块患者,经组织活检或病理证实良性肿块105例(良性组)、恶性肿块57例(恶性组)。对比良、恶性组SWE的典型表现、SWE参数[最大值(Emax)、最小值(Emin)、平均值(Emean)、标准差(SD)、病灶与邻近脂肪弹性比值(SWE-Ratio)]的差异,分析SWE鉴别诊断乳腺良恶性病变的价值。结果:恶性组乳腺肿块"硬边征"检出率、Ⅲ型～Ⅴ型弹性图像检出率、Emax、Emean、SD、SWE-Ratio均高于良性组(P0.05),Emin低于良性组(P0.05)。Logistic多元回归分析结果显示,"硬边征"、Emax、Emean、SWE-Ratio与病理诊断乳腺肿块性质独立相关(P0.05)。受试者工作特征(ROC)曲线分析结果显示,"硬边征"、Emax、Emean、SWE-Ratio鉴别诊断乳腺良恶性病变的曲线下面积(AUC)分别为0.923、0.686、0.873、0.879。结论:SWE是诊断乳腺良恶性病变的有效影像手段,SWE的"硬边征"、SWE-Ratio、Emean对乳腺良恶性病变具有较高的鉴别价值。

Typical Manifestations and Differential Diagnostic Value of Shear Wave Elastography in Benign and Malignant Breast Lesions

ABSTRACT Objective: To observe the typical performance of shear wave elastography (SWE) in benign and malignant breast lesions, and to explore the value of SWE in differential diagnosis of benign and malignant breast lesions. Methods: 162 patients with breast masses who underwent SWE examination in our hospital from June 2017 to June 2019 were selected. 105 cases of benign masses (benign group) and 57 cases of malignant masses (malignant group) were confirmed by biopsy or pathology. The differences of SWE typical performance, SWE parameters [Emax, Emin, Emean, standard deviation (SD), SWE-Ratio] between benign and malignant breast lesions were compared, and the value of SWE in differentiating benign and malignant breast lesions was analyzed. Results: The detection rate of "stiff rim sign", elastic image of type III-type V, Emax, Emean, SD and SWE-Ratio of breast masses in malignant group were higher than those in benign group (P<0.05), and Emin was lower than that in benign group (P<0.05). Logistic regression analysis showed that "stiff rim sign", Emax, Emean and SWE-Ratio were independently correlated with the pathological diagnosis of breast mass (P<0.05). The results of receiver operator characteristics curve (ROC) curve analysis show that the area under curve (AUC) of "stiff rim sign", Emax, Emean and SWE-Ratio in diagnosing benign and malignant breast lesions were 0.923, 0.686, 0.873 and 0.879, respectively. Conclusion: SWE is an effective imaging method in the diagnosis of benign and malignant breast lesions. SWE "stiff rim sign", SWE-Ratio and Emean have high value in differentiating benign and malignant breast lesions.