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中华医学超声杂志(电子版) ›› 2020, Vol. 17 ›› Issue (10) : 993 -998. doi: 10.3877/cma.j.issn.1672-6448.2020.10.011

所属专题: 乳腺超声 文献

浅表器官超声影像学

高频超声联合弹性应变率比值与磁共振成像诊断乳腺癌的临床价值比较
施海建1, 丁洁2,(), 姥义1   
  1. 1. 214044 无锡,解放军联勤保障部队第九〇四医院超声科
    2. 214000 南京医科大学附属无锡市妇幼保健院超声科
  • 收稿日期:2019-12-08 出版日期:2020-10-01
  • 通信作者: 丁洁

Comparison of high frequency ultrasound combined with elastography strain rate ratio versus magnetic resonance imaging in diagnosis of breast cancer

Haijian Shi1, Jie Ding2,(), Yi Mu1   

  1. 1. Department of Ultrasound, the 904th Hospital of the PLA Joint Service Support Force, Wuxi 214044, China
    2. Department of Ultrasound, Wuxi Maternal and Child Health-Care Hospital Affiliated to Nanjing Medical University, Wuxi 214000, China
  • Received:2019-12-08 Published:2020-10-01
  • Corresponding author: Jie Ding
  • About author:
    Corresponding author: Ding Jie, Email:
引用本文:

施海建, 丁洁, 姥义. 高频超声联合弹性应变率比值与磁共振成像诊断乳腺癌的临床价值比较[J/OL]. 中华医学超声杂志(电子版), 2020, 17(10): 993-998.

Haijian Shi, Jie Ding, Yi Mu. Comparison of high frequency ultrasound combined with elastography strain rate ratio versus magnetic resonance imaging in diagnosis of breast cancer[J/OL]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2020, 17(10): 993-998.

目的

比较高频超声联合弹性应变率比值与磁共振成像(MRI)诊断乳腺癌的临床应用价值。

方法

回顾性选取2016年5月至2017年4月因乳腺肿块在中国人民解放军联勤保障部队第九〇四医院甲乳外科就诊的65例患者,共84个病灶。所有病灶均经穿刺或手术取得病理结果。所有患者穿刺或手术前均行高频超声及弹性成像检查,且行增强MRI扫描。以病理结果为"金标准",绘制ROC曲线,得出高频超声联合弹性应变率比值诊断乳腺癌的敏感度、特异度、准确性,利用四格表计算MRI诊断乳腺癌的敏感度、特异度、准确性,对二者的诊断效能进行分析比较。

结果

病理结果显示,84个病灶中,良性肿块47个,乳腺癌病灶37个。高频超声结合弹性应变率比值诊断乳腺癌的ROC曲线下面积为0.892,弹性应变率比值最佳截断值为3.01,诊断敏感度、特异度、准确性分别为91.9%、89.4%、90.5%。MRI诊断乳腺癌的敏感度、特异度、准确性分别为94.6%、89.4%、91.7%。高频超声联合弹性应变率比值与MRI诊断效能均较高,差异无统计学意义(P均>0.05)。

结论

弹性应变率比值是反映乳腺肿块硬度的重要指标,结合高频超声对乳腺癌具有良好的诊断效能;与MRI相比,其具有便捷、高效、费用低等优点,更适用于乳腺癌的早期筛查。

Objective

To compare the clinical application value of high frequency ultrasound combined with elastography strain rate ratio (SRR) versus magnetic resonance imaging (MRI) in the diagnosis of breast cancer.

Methods

A retrospective analysis was performed on 65 patients with 84 breast lesions at The 904th Hospital of the PLA Joint Service Support from May 2016 to April 2017. Pathological results were obtained through puncture or surgery for all lesions. High frequency ultrasound and elastography were performed in all patients before puncture or operation, and enhanced MRI scanning was performed. ROC analysis was performed with pathological results as the "gold standard" to calculate the sensitivity, specificity, and accuracy of high frequency ultrasound combined with elastic SRR in the diagnosis of breast cancer. The sensitivity, specificity, and accuracy of MRI for diagnosis of breast cancer were also calculated using the four-fold table.

Results

The pathological results showed 47 benign masses and 37 breast cancer lesions. The area under ROC curve of high frequency ultrasound combined with SRR was 0.892. With an SRR threshold of 3.01, the accuracy, sensitivity, and specificity of SRR for diagnosis of breast cancer were 91.9%, 89.4%, and 90.5%, respectively. The sensitivity, specificity, and accuracy of MRI in the diagnosis of breast cancer were 94.6%, 89.4%, and 91.7%, respectively. The sensitivity, specificity, and accuracy of high frequency ultrasound combined with elastic SRR and MRI in the diagnosis of breast cancer were both high, and there was no significant difference between them (P>0.05).

Conclusion

The elastic SRR is an important index to reflect the hardness of breast lesions. Combining two-dimensional ultrasound and color Doppler blood flow characteristics has good diagnostic efficacy for breast cancer. Compared with MRI, high frequency ultrasound combined with SRR has the advantages of quickness, high efficiency, and low cost, and is more suitable for early screening of breast neoplasms.

图1 乳腺癌高频超声二维图像及弹性应变率比值测量。图a为乳腺癌高频超声表现为形态不规则,边界不清,呈低回声,边缘呈毛刺状;图b为超声弹性成像示乳腺癌与同深度周围正常组织的弹性应变率比值为3.84
图2 乳腺癌MRI图像及时间-信号强度曲线。图a为增强后脂肪抑制的快速自旋回波加强序列T1加权成像显示病灶边缘呈毛刺状,动态增强时,呈边缘性强化;图b示时间-信号强度曲线表现为III型(流出型,信号强度早期增强达高峰后快速下降)
图3 高频超声结合弹性应变率比值诊断乳腺癌的ROC曲线
表1 乳腺良恶性肿块的MRI检查与病理诊断结果对比(个)
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