超声BI-RADS分类标准联合剪切波弹性成像技术鉴别诊断乳腺良恶性病灶的价值
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摘要
目的·探讨2013版超声乳腺影像报告和数据系统(breast imaging reporting and data system,BI-RADS)分类诊断标准结合剪切波弹性成像技术(shear wave elastography,SWE)鉴别乳腺良恶性病灶的价值。方法·对155例患者共175个乳腺病灶行常规超声检查,并用BI-RADS分类诊断标准判断其良恶性;再行剪切波弹性成像检测,获得乳腺良恶性病灶的剪切波定量参数。以病理结果为金标准,构建受试者操作特征(ROC)曲线,比较2种方法单独应用及联合应用的诊断价值。结果·BI-RADS分类诊断标准、SWE技术及两者联合鉴别诊断乳腺良恶性结节的曲线下面积(AUC)分别为0.913、0.884和0.957,三者两两比较,2种方法单独使用与两者联合应用的AUC差异皆有统计学意义(BI-RADS分类vs两者联合:Z=2.883,P=0.002;SWE技术vs两者联合:Z=4.081,P=0.000)。结论·BI-RADS分类与SWE技术联合可以提高乳腺病灶的诊断准确性。
Objective · To explore the value of the 2013 version of the ultrasound breast imaging reporting and data system(BI-RADS) classification diagnostic criteria combined with ultrasound shear wave elastography(SWE) to identify benign and malignant breast lesions. Methods · A total of 175 solid breast masses in 155 women were examined with ultrasound, and were judged to be benign or malignant by BI-RADS classification criteria. Then all the masses were examined with shear wave elastography(SWE), to obtain shear wave quantitative parameters of benign and malignant breast lesions,the pathological results were used as the gold standard to construct the receiver operating characteristic(ROC) curve of the subjects, which were used to compare the diagnostic value of the two methods alone and in combination. Results · The area under curve(AUC) of the BI-RADS classification diagnostic criteria, the Emax value, and the combination of the two methods to differential diagnosis of benign and malignant breast nodules were 0913, 0.884 and 0.957, respectively. Through pairwise comparison, there was significant difference in AUC between the two methods alone and their combination(BI-RADS classification vs. combination: Z=2.883, P=0.002; SWE vs. combination: Z=4.081, P=0.000). Conclusion · The combination of BI-RADS classification and SWE technology can improve the diagnostic accuracy of breast lesions.
Objective · To explore the value of the 2013 version of the ultrasound breast imaging reporting and data system(BI-RADS) classification diagnostic criteria combined with ultrasound shear wave elastography(SWE) to identify benign and malignant breast lesions. Methods · A total of 175 solid breast masses in 155 women were examined with ultrasound, and were judged to be benign or malignant by BI-RADS classification criteria. Then all the masses were examined with shear wave elastography(SWE), to obtain shear wave quantitative parameters of benign and malignant breast lesions,the pathological results were used as the gold standard to construct the receiver operating characteristic(ROC) curve of the subjects, which were used to compare the diagnostic value of the two methods alone and in combination. Results · The area under curve(AUC) of the BI-RADS classification diagnostic criteria, the Emax value, and the combination of the two methods to differential diagnosis of benign and malignant breast nodules were 0913, 0.884 and 0.957, respectively. Through pairwise comparison, there was significant difference in AUC between the two methods alone and their combination(BI-RADS classification vs. combination: Z=2.883, P=0.002; SWE vs. combination: Z=4.081, P=0.000). Conclusion · The combination of BI-RADS classification and SWE technology can improve the diagnostic accuracy of breast lesions.
引文
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[11]Barr RG,Zhang Z.Shear-wave elastography of the breast:value of a quality measure and comparison with strain elastography[J].Radiology,2015,275(1):45-53.
[12]Bai M,Zhang HP,Xing JF,et al.Acoustic radiation force impulse technology in the differential diagnosis of solid breast masses with different sizes:which features are most efficient?[J].Biomed Res Int,2015,2015:1-8.
[13]Evans A,Whelehan P,Thomson K,et al.Invasive breast cancer:relationship between shear-wave elastographic findings and histologic prognostic factors[J].Radiology,2012,263(3):673-677.
[2]Zuo TT,Zheng RS,Zeng HM,et al.Female breast cancer incidence and mortality in China,2013[J].Thoracic Cancer,2017,8(3):214-218.
[3]詹维伟,周建桥.乳腺超声影像报告与数据系统解读[M].北京:人民卫生出版社,2015:3-4.
[4]Barr RG,Nakashima K,Amy D,et al.WFUMB guidelines and recommendations for clinical use of ultrasound elastography:Part 2:breast[J].Ultrasound Med Bio,2015,41(5):1148-1160.
[5]Spak DA,Plaxco JS,Santiago L,et al.BI-RADS?fifth edition:a summary of changes[J].Diagn Interv Imaging,2017,98(3):179-190.
[6]Oh HY,Han H,Kim SS,et al.Efficacy of the various combinations of US BI-RADS lexicons for the differentiation of benign and malignant breast masses[J].Curr Med Imaging Rev,2018,13(4):569-575.
[7]Stavros AT,Freitas AG,de Mello GGN,et al.Ultrasound positive predictive values by BI-RADS categories 3-5 for solid masses:an independent reader study[J].Eur Radiol,2017,27(10):4307-4315.
[8]Zhang Y,Guo Y,Lee WN.Ultrafast ultrasound imaging using combined transmissions with cross-coherence-based reconstruction[J].IEEE Trans Med Imaging,2017,37(2):337-348.
[9]Hong S,Woo OH,Shin HS,et al.Reproducibility and diagnostic performance of shear wave elastography in evaluating breast solid mass[J].Clin Imaging,2017,44:42-45.
[10]梁萍,姜玉新.超声E成像临床应用指南[M].北京:人民卫生出版社,2018:13-16.
[11]Barr RG,Zhang Z.Shear-wave elastography of the breast:value of a quality measure and comparison with strain elastography[J].Radiology,2015,275(1):45-53.
[12]Bai M,Zhang HP,Xing JF,et al.Acoustic radiation force impulse technology in the differential diagnosis of solid breast masses with different sizes:which features are most efficient?[J].Biomed Res Int,2015,2015:1-8.
[13]Evans A,Whelehan P,Thomson K,et al.Invasive breast cancer:relationship between shear-wave elastographic findings and histologic prognostic factors[J].Radiology,2012,263(3):673-677.