标题：超声造影联合SWE技术对乳腺肿瘤的诊断价值

      作者：侯广立 1，杜苗苗 1，王桃英 1，邱海静 2    西安医学院第二附属医院门诊超声科 1、影像科 2，陕西 西安 710038

      卷次： 2021年32卷23期

      【摘要】 目的 探讨超声造影联合剪切波弹性成像(SWE)技术对乳腺肿瘤的诊断价值。方法 回顾性分析2019年12月至2020年12月在西安医学院第二附属医院治疗的120例乳腺肿瘤患者的临床和影像资料，依据病理结果将患者分为恶性组 64例和良性组 56例。所有患者均实施超声造影与SWE检查，比较两组患者达峰增强方向、增强水平、增强肿块大小与造影剂分布均匀程度、最小弹性模量值(Emin)、最大弹性模量值(Emax)、病灶脂肪弹性比(Eratio)、平均弹性模量值(Emean)以及超声造影与 SWE单独及联合对乳腺肿瘤良恶性诊断的准确度、灵敏度、特异度。结果 恶性组患者的达峰增强离心性、造影剂分布不均匀分别占 51.56%、56.25%，与良性组的 64.29%、46.43%比较差异均无统计学意义(P>0.05)；恶性组患者的高增强水平、增强肿块增大分别占92.19%、81.25%，明显高于良性组的51.78%、28.57%，差异均有统计学意义(P<0.05)；恶性组患者的Emax、Eratio、Emean分别为(70.02±20.94) kPa、(6.18±1.77) kPa、(43.62±13.38) kPa，明显高于良性组的(31.18±9.56) kPa、(2.64±0.81) kPa、(22.29±6.06) kPa，Emin为(8.23±2.19) kPa，明显低于良性组的(11.27±3.26) kPa，差异均有统计学意义(P<0.05)；联合检查对乳腺肿瘤良恶性诊断的准确度、灵敏度、特异度分别为95.83%、95.31%、96.43%，明显高于超声造影的81.67%、78.13%、85.71%与SWE的85.53%、85.94%、85.71%，差异均有统计学意义(P<0.05)。结论 超声造影联合SWE技术鉴别良恶性乳腺肿瘤能明显提高诊断的准确度、灵敏度、特异度。
      【关键词】 乳腺肿瘤；超声造影；剪切波弹性成像；诊断价值；准确度；灵敏度；特异度
      【中图分类号】 R737.9 【文献标识码】 A 【文章编号】 1003—6350（2021）23—3097—04

Diagnostic value of contrast-enhanced ultrasound combined with shear wave elastography technology for breasttumors.
HOU Guang-li 1, DU Miao-miao 1, WANG Tao-ying 1, QIU Hai-jing 2. Department of Ultrasound 1, Department ofImaging 2, Second Affiliated Hospital of Xi'an Medical College, Xi'an 710038, Shaanxi, CHINA
【Abstract】 Objective To explore the diagnostic value of contrast-enhanced ultrasound combined with shearwave elastography (SWE) technology for breast tumors. Methods The clinical and imaging data of 120 breast tumorpatients treated in the Second Affiliated Hospital of Xi'an Medical College from December 2019 to December 2020were retrospectively analyzed. The patients were divided into malignant group (64 cases) and benign group (56 cases)based on the pathological results. All patients underwent contrast-enhanced ultrasound and SWE examinations. Thepeak enhancement direction, enhancement level, enhanced tumor size and uniformity of contrast agent distribution,minimum elastic modulus (Emin), maximum elastic modulus (Emax), and lesions fat elasticity ratio (Eratio), average elasticmodulus value (Emean) were compared between the two groups, as well as the accuracy, sensitivity, and specificity ofcontrast-enhanced ultrasound and SWE alone and in combination in the diagnosis of benign and malignant breast tu-mors. Results Peak enhanced eccentricity and uneven distribution of contrast agent accounted for 51.56% and 56.25%in the malignant group versus 64.29% and 46.43% in the benign group, and the differences were not statistically signifi-cant (P>0.05). The high enhancement level and enhancement mass increase in the malignant group accounted for92.19% and 81.25%, which were significantly higher than 51.78% and 28.57% in the benign group (P<0.05). Emax, Eratio,and Emean in the malignant group were (70.02±20.94) kPa, (6.18±1.77) kPa, (43.62±13.38) kPa, which were significant-ly higher than (31.18±9.56) kPa, (2.64±0.81) kPa, (22.29±6.06) kPa in the benign group, and Emin was (8.23±2.19) kPa,significantly lower than (11.27±3.26) kPa of the benign group (P<0.05). The accuracy, sensitivity, and specificity ofcombined examination in the diagnosis of benign and malignant breast tumors were 95.83%, 95.31%, and 96.42%, sig-nificantly higher than 81.67% , 78.13% , 85.71% of contrast-enhanced ultrasound and 85.53% , 85.94% , 85.71% ofSWE (P<0.05). Conclusion Contrast-enhanced ultrasound combined with SWE technology is more effective in iden-tifying benign and malignant breast tumors, and can significantly improve the accuracy, sensitivity, and specificity ofdiagnosis.
      【Key words】 Breast tumors; Contrast-enhanced ultrasound; Shear wave elastography; Diagnostic value; Accura-cy; Sensitivity; Specificity