Breast ultrasound elastography-Results of 193 breast lesions in a prospective study with histopathologic correlation
Breast ultrasound elastography-Results of 193 breast lesions in a prospective study with histopathologic correlation
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DOI：
10.1016/j.ejrad.2009.08.026
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发表时间：
2011-03-01
影响因子：
3.3
通讯作者：
Schreer, I.
中科院分区：
文献类型：
--
作者：
Schaefer, F. K. W.;Heer, I.;Schreer, I.
目的：评价超声弹性成像对乳腺肿块的诊断价值。材料与方法：采用日本日立公司EUB8500型超声诊断仪和7.5~13 MHz的线阵探头，对乳腺肿块的超声弹性成像进行分析。参考标准为细胞学(细针抽吸)或组织学(核心活检)。弹性评分按6分彩色分级(Ueno分级，1-3=良性，4-5=恶性)。根据BI-RADS分类对常规B型超声(US)所见进行分类。结果：恶性病变的平均弹性评分为4.1+/-0.9，良性病变为2.1+/-1.0(p<；0.001)。以弹性评分3~4为最佳分界点，敏感度为96.9%，特异度为76%。以BI-RADS4~5作为常规超声诊断的最佳界点，其敏感性为57.8%，特异性为96.1%。与常规超声相比，弹性成像具有更高的敏感性和更低的特异性，但有2个弹性评分为1的病变为假阴性，而BI-RADS 1~3分的病变均为假阴性。ROC曲线弹性图为0.884，常规超声为0.820(p<；0.001)。BI-RADS分级的加权Kappa值为0.784/0.634，弹性评分为0.720/0.561。结论：在我们的研究背景下，弹性成像在乳腺癌的检测中没有取代传统B超的潜力，但可以补充传统的US以提高诊断性能。(C)2009爱思唯尔爱尔兰有限公司。保留所有权利。
Purpose: To evaluate the diagnostic performance of ultrasound elastography in breast masses.Material and methods: 193 lesions (129 benign, 64 malignant) were analyzed with the EUB 8500 Logos-ultrasonic-unit (Hitachi Medical, Japan) and a linear-array-transducer of 7.5-13-MHz. Standard of reference was cytology (FNAfine needle aspiration) or histology (core biopsy). The elastic-score was classified according to a 6-point colour-scale (Ueno classification; 1-3 = benign, 4-5 = malignant). Conventional B-mode ultrasound (US) findings were classified according to the BI-RADS classification. Statistical analysis included sensitivity, specificity, ROC-analysis and kappa-values for intra-/interobserver reliability.Results: The mean score for elasticity was 4.1 +/- 0.9 for malignant lesions, and 2.1 +/- 1.0 for benign lesions (p < 0.001). With a best cut-off point between elasticity scores 3 and 4, sensitivity was 96.9%, and specificity 76%. Setting a best cut-off point for conventional US between BI-RADS 4 and 5, sensitivity was 57.8%, and specificity 96.1%. Elastography provided higher sensitivity and lower specificity than conventional US, but two lesions with elasticity score 1 were false negative, whereas no lesion scored BI-RADS 1-3 were false negative. ROC-curve was 0.884 for elastography, and 0.820 for conventional US (p < 0.001). Weighted kappa-values for intra-/interobserver reliability were 0.784/0.634 for BI-RADS classification, and 0.720/0.561 for elasticity scores.Conclusion: In our study setting, elastography does not have the potential to replace conventional B-mode US for the detection of breast cancer, but may complement conventional US to improve the diagnostic performance. (C) 2009 Elsevier Ireland Ltd. All rights reserved.