摘要
目的：探讨弹性应变率比值（Strain ratio，SR）在乳腺微小实性病灶（≤10 mm）良恶性鉴别诊断中的价值。方法：对165例共184个乳腺微小病灶进行术前超声实时组织弹性成像（Ultrasonography real-time tissue elastography，URTE）检查，采用SR法分析计算病灶与周围对照组织的SR及其平均值。以病理诊断为金标准，构建受试者工作特征曲线（Receiver operating characteristic，ROC），获得SR的最佳诊断临界值并分析其对乳腺微小实性病灶良恶性鉴别诊断的价值。结果：184个乳腺病灶中，良性114个，恶性70个。良、恶性病灶SR平均值分别为1.81±0.334，2.92±0.753。根据本组良恶性病灶SR绘制的ROC曲线，曲线下面积（Area under the ROC curve，AUC）为0.891，面积标准误为0.023。面积的95%可信区间为0.846~0.935，不包括0.5，P=0.000，差异具有显著统计学意义。通过ROC曲线分析确定良恶性病灶SR的最佳诊断临界值为2.165。其对应的诊断敏感性（Se）81.4%，特异性（Sp）77.2%，约登指数（YI）为0.586，Se与Sp之和最大（1.586），误诊率与漏诊率之和最小（0.414）。结论：SR能提供乳腺微小实性病灶硬度信息，有助于病灶的良恶性鉴别诊断。
Abstract
Objective: To evaluate the diagnostic value of strain ratio(SR) in the differential diagnosis of benign and malignant minimal solid breast masses(the largest diameter ≤10 mm) masses. Methods: By analyzing 184 breast lesions in real-time ultrasound elastography images. Calculated the mean SR of each lesion with the surrounding tissues, pathological result was used as the diagnostic standard, receiver operating characteristic(ROC) curve was used for statistical analysis to determine the optimal diagnostic threshold fo benign and malignant breast lesions. Results: The average SR of benign lesions was significantly lower than that of malignant ones (1.81±0.334) vs (2.92±0.753). According to the ROC curve, the area under the ROC curve was 0.891, the area of the standard error was 0.023 and area of the 95% confidence inteval(0.846~0.935), not including 0.5, P=0.000. There was significant difference. The best cut-off point for SR was 2.165. Its corresponding sensitivity(Se), specificity(Sp) was 81.4% and 77.2% respectively. The Youden index（YI） was 0.586. The Se and Sp was maximum (1.586) and the missed diagnosis and misdiagnosis rate was minimal(0.414). Conclusions: SR analysis is useful for the diagnosis of benign and malignant tiny solid breast masses.
关键词
乳腺肿瘤 /
乳腺疾病 /
超声检查 /
多普勒 /
彩色
Key words
Breast neoplasms /
Breast diseases /
Ultrasonography /
Doppler /
color
沈锡琳;龙春艳;卢丽萍;莫春生;王 昆;曹修淮;刘文辉.
乳腺微小实性病灶的弹性应变率比值分析[J]. 中国临床医学影像杂志. 2013, 24(11): 772-776
SHEN Xi-lin;LONG Chun-yan;LU Li-ping;MO Chun-sheng;WANG Kun;CAO Xiu-huai;LIU Wen-hui.
Value of strain ratio in the tiny solid breast masses[J]. Journal of China Clinic Medical Imaging. 2013, 24(11): 772-776
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