超声造影联合剪切波弹性成像评估乳腺癌病灶可切除性的研究

doi:10.7517/issn.1674-0475.220826

摘要/Abstract

摘要： 探讨超声造影(CEUS)联合剪切波弹性成像(SWE)评估乳腺癌病灶可切除性的价值。本文选取103例乳腺癌患者作为研究对象,根据临床实际分为手术切除组(61例)与不可手术切除组(42例),均行CEUS、SWE检查。结果发现:不可手术切除组达峰时间(TTP)短于手术切除组。峰值强度(PI)、上升支斜率(WIS),以及杨氏模量值平均值(Emean)、最小值(Emin)、最大值(Emax)均高于手术切除组。TTP与Emean、Emin、Emax呈负相关,PI、WIS与Emean、Emin、Emax呈正相关(P＜0.05)。TTP低水平患者不可手术切除的风险是高水平患者的2.084倍,PI、WIS、Emean、Emin、Emax高水平患者不可手术切除的风险分别是低水平患者的1.883倍、2.179倍、2.443倍、1.894倍、2.003倍。TTP、PI、WIS、Emean、Emin、Emax联合评估乳腺癌病灶可切除性的AUC为0.916,敏感度为85.71%,特异度为83.61%,优于各参数单独评估。提示CEUS联合SWE评估乳腺癌病灶可切除性的价值较为可靠,可为临床准确评估手术可行性提供参考依据。

关键词: 乳腺癌, 可切除性, 超声造影, 剪切波弹性成像, 杨氏模量

Abstract: The value of contrast-enhanced ultrasound (CEUS) combined with shear wave elastography (SWE) in evaluating the resectability of breast cancer lesions were investigated. In this study, 103 breast cancer patients were selected as the research subjects, and they were divided into a surgical resection group (61 cases) and an inoperable group (42 cases) according to clinical conditions, all of whom underwent CEUS and SWE examinations. The results showed that the time to peak (TTP) in the inoperable group was shorter than that in the surgical resection group. The peak intensity (PI), the wash in slop (WIS), the mean value of Young’s modulus (Emean), the minimum value of Young’s modulus (Emin) and maximum value of Young’s modulus (Emax) were higher than those in the surgical resection group. TTP was negatively correlated with Emean, Emin and Emax, while PI and WIS were positively correlated with Emean, Emin and Emax (P<0.05). The risk of inoperable resection was 2.084 times higher in patients with low levels of TTP than in patients with high levels. The risk of inoperable resection in patients with high PI, WIS, Emean, Emin, and Emax levels was 1.883 times, 2.179 times, 2.443 times, 1.894 times, and 2.003 times higher than that in patients with low levels, respectively. The combined AUC of TTP, PI, WIS, Emean, Emin, and Emax for assessing the resectability of breast cancer lesions was 0.916, with a sensitivity of 85.71% and specificity of 83.61%, which was better than each parameter individually. It is suggested that the value of CEUS combined with SWE to assess the resectability of breast cancer lesions is more reliable and can provide a reference basis for accurate clinical assessment of surgical feasibility.

Key words: breast cancer, resectability, ultrasonography, shear wave elastography, Young’s modulus

宫文亮, 周建, 朱道伟. 超声造影联合剪切波弹性成像评估乳腺癌病灶可切除性的研究[J]. 影像科学与光化学, 2022, 40(6): 1375-1380.

GONG Wenliang, ZHOU Jian, ZHU Daowei. Evaluation of Resectability of Breast Cancer Lesions by Contrast-enhanced Ultrasound Combined with Shear Wave Elastography[J]. IMAGING SCIENCE AND PHOTOCHEMISTRY, 2022, 40(6): 1375-1380.

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