Clinical application of shear wave elastography (SWE) in the diagnosis of benign and malignant breast diseases
Clinical application of shear wave elastography (SWE) in the diagnosis of benign and malignant breast diseases
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DOI：
10.1007/s10549-011-1627-7
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发表时间：
2011-08-01
影响因子：
3.8
通讯作者：
Kim, Seung Ja
中科院分区：
文献类型：
--
作者：
Chang, Jung Min;Moon, Woo Kyung;Kim, Seung Ja
剪切波弹性成像（SWE）是一种新兴的技术，可以获得定量的弹性值在乳腺疾病。因此，我们评价了与传统超声（US）相比，SWE对乳腺肿块的鉴别诊断性能。由3名经验丰富的放射科医生对158名连续女性进行常规US和SWE，这些女性计划在182个乳腺肿块（89个恶性肿瘤和93个良性肿瘤;平均大小为1.76 cm）中进行US引导下空芯活检或手术切除。对于每个病变，使用SWE测量杨氏模量（单位为kPa）的定量弹性，并使用常规US评估BI-RADS最终类别。恶性肿块的平均弹性值（153.3kPa +/-A58.1）明显高于良性肿块（46.1kPa +/-A42.9）（P < 0.0001）。浸润性导管癌（157.5 ± A57.07）和浸润性小叶癌（169.5 ± A61.06）的平均弹性值高于导管原位癌（117.8kPa ± A54.72）。纤维腺瘤的平均值为49.58 +/- A 43.51，纤维囊性变为35.3 +/- A 31.2，导管内乳头状瘤为69.5 +/- A 63.2，腺病或间质纤维化为149.5 +/- A 132.4。SWE的敏感性和特异性之和最大的临界值为80.17 kPa，SWE的敏感性和特异性分别为88.8%（79/89）和84.9%（79/93）。常规超声的ROC曲线下面积（Az值）为0.898，SWE为0.932，组合数据为0.982。总之，良性和恶性肿块以及浸润性和导管内癌的弹性值与SWE有显着差异。我们的研究结果表明，SWE有可能帮助区分良性和恶性乳腺病变。
Shear wave elastography (SWE) is an emerging technique which can obtain quantitative elasticity values in breast disease. We therefore evaluated the diagnostic performance of SWE for the differentiation of breast masses compared with conventional ultrasound (US). Conventional US and SWE were performed by three experienced radiologists for 158 consecutive women who had been scheduled for US-guided core biopsy or surgical excision in 182 breast masses (89 malignancies and 93 benign; mean size, 1.76 cm). For each lesion, quantitative elasticity was measured in terms of the Young's modulus (in kilopascals, kPa) with SWE, and BI-RADS final categories were assessed with conventional US. The mean elasticity values were significantly higher in malignant masses (153.3 kPa +/- A 58.1) than in benign masses (46.1 kPa +/- A 42.9), (P < 0.0001). The average mean elasticity values of invasive ductal (157.5 +/- A 57.07) or invasive lobular (169.5 +/- A 61.06) carcinomas were higher than those of ductal carcinoma in situ (117.8 kPa +/- A 54.72). The average mean value was 49.58 +/- A 43.51 for fibroadenoma, 35.3 +/- A 31.2 for fibrocystic changes, 69.5 +/- A 63.2 for intraductal papilloma, and 149.5 +/- A 132.4 for adenosis or stromal fibrosis. The optimal cut-off value, yielding the maximal sum of sensitivity and specificity, was 80.17 kPa, and the sensitivity and specificity of SWE were 88.8% (79 of 89) and 84.9% (79 of 93). The area under the ROC curve (Az value) was 0.898 for conventional US, 0.932 for SWE, and 0.982 for combined data. In conclusion, there were significant differences in the elasticity values of benign and malignant masses as well as invasive and intraductal cancers with SWE. Our results suggest that SWE has the potential to aid in the differentiation of benign and malignant breast lesions.