应变弹性成像评估乳腺肿块周围组织硬度在乳腺病变良恶性鉴别中的临床价值OA
Clinical value of strain elastography in assessing perilesional tissue stiffness of breast masses for differentiating benign and malignant breast lesions
目的 探讨应变弹性成像(SE)中的应变比(SR)在评估乳腺肿块周围组织硬度中的应用价值.方法 对2023年9月～2025年7月在蚌埠医科大学第一附属医院接受手术治疗的195例女性共195个乳腺肿块进行常规超声和SE检查.采用应变比评估方法半定量地评估乳腺肿块及其周围不同区域组织的硬度,采用Pearson相关分析法分析乳腺肿块与周围组织的应变比的相关性;绘制ROC曲线分析常规超声、SE各弹性参数以及常规超声联合最优SE弹性参数的诊断效能.结果 恶性病变91例,良性病变104例.乳腺恶性肿块及其周围组织1、2、3 mm的应变比高于良性组,差异有统计学意义(P<0.001);相关性分析显示,在恶性组中,肿块与周围组织1 mm的应变比相关性最高(r=0.91,P<0.001).ROC曲线结果显示,SE参数(B/shell 1组)的诊断效能最佳,其诊断的敏感度、特异度及准确率分别为89%、82.7%及85.6%,AUC=0.921,BI-RADS分类联合B/shell 1组的诊断效能进一步提高(AUC=0.944).结论 乳腺恶性肿块周围组织硬度高于良性肿块,肿块与周围组织1 mm区域的应变比显著相关;肿块周围组织1 mm区域的应变比为诊断乳腺肿块良恶性最优SE弹性参数,其联合BI-RADS分类可进一步提高诊断性能.
Objective To explore the clinical value of the strain ratio(SR)technique in strain elastography(SE)for evaluating the stiffness of perilesional tissue around breast masses.Methods A total of 195 female patients with 195 breast masses who underwent surgical treatment at the First Affiliated Hospital of Bengbu Medical University from September 2023 to July 2025 were prospectively enrolled.All patients underwent both conventional ultrasound and SE examinations.The strain ratio method was used to semi-quantitatively assess the stiffness of breast masses and their perilesional tissues at 1 mm,2 mm,and 3 mm distances.Pearson correlation analysis was performed to examine the correlation between the strain ratios of the masses and their corresponding perilesional tissues.ROC curves were constructed to compare the diagnostic performance of conventional ultrasound,individual SE parameters,and the combination of conventional ultrasound with the optimal SE parameter.Results Among the 195 masses,91 were malignant and 104 were benign.The strain ratios of malignant masses and their 1 mm,2 mm,and 3 mm perilesional tissues were significantly higher than those of the benign group(P<0.001).Correlation analysis revealed that in the malignant group,the strain ratio between the mass and its 1 mm perilesional tissue exhibited the strongest correlation(r=0.91,P<0.001).ROC curve analysis demonstrated that the SE parameter(B/shell 1)achieved the best diagnostic performance,with a sensitivity of 89%,specificity of 82.7%,accuracy of 85.6%,and an area under the curve(AUC)of 0.921.The combination of BI-RADS classification and B/shell 1 further improved diagnostic efficacy,yielding an AUC of 0.944.Conclusion The perilesional tissue surrounding malignant breast masses exhibits higher stiffness than that around benign masses,and the strain ratio between the mass and its 1 mm perilesional tissue shows a significant correlation.The strain ratio of the 1 mm perilesional tissue(B/shell 1)is the optimal SE parameter for differentiating benign and malignant breast masses,and its combination with BI-RADS classification can further enhance diagnostic performance.
董康;崔煦焓;刘银;范晨晨;张晓静;王兵
蚌埠医科大学第一附属医院 超声医学科,安徽 蚌埠 233000蚌埠医科大学第一附属医院 超声医学科,安徽 蚌埠 233000蚌埠医科大学第一附属医院 超声医学科,安徽 蚌埠 233000蚌埠医科大学第一附属医院 超声医学科,安徽 蚌埠 233000蚌埠医科大学第一附属医院 肿瘤外科,安徽 蚌埠 233000蚌埠医科大学第一附属医院 超声医学科,安徽 蚌埠 233000
弹性成像应变率比值乳腺癌周围组织
elastographystrain ratiobreast cancerperilesional tissue
《分子影像学杂志》 2026 (2)
190-196,7
安徽省高等学校科学研究项目(2023AH051944)
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