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目的 :探讨纤维腺瘤实时剪切波弹性成像(shear wave elastography,SWE)影响因素及解决策略,以期进一步减少纤维腺瘤的活检率。方法:回顾性分析115个经病理证实为乳腺纤维腺瘤的常规超声及SWE成像特征,根据弹性彩色图像分类法将SWE彩色图像分为4种类型,测量病灶的最大弹性模量值E_(max),最小弹性模量值Emin,平均弹性模量值Emean,弹性标准差Estd值。分析SWE彩色图像特征及弹性模量值与年龄、病灶的包膜回声、病灶最大径、距乳头距离、距胸大肌距离、病理改变及BI-RADS分类的相关性。结果 :根据常规超声、SWE彩色图像特征及弹性模量值E_(max),病灶的活检率分别为59.1%、27.0%、13.0%。E_(max)和SWE彩色图像特征与病灶的最大径有显著相关性(P<0.05)。E_(max)与病灶距胸大肌距离有显著相关性(P<0.05)。结论:SWE可以明显减少乳腺纤维腺瘤的活检率,病灶最大径、距胸大肌距离是纤维腺瘤SWE成像的重要影响因素。
Objective: To investigate the influencing factors and strategies of real-time shear wave elastography (SWE) of fibroadenoma in order to further reduce the biopsy rate of fibroadenoma. Methods: One hundred and fifteen conventional ultrasound and SWE imaging features of breast fibroadenoma confirmed by pathology were retrospectively analyzed. The color images of SWE were classified into four types according to the elastic color image classification, and the maximum elastic modulus value (E max ), The minimum elastic modulus value Emin, the average elastic modulus value Emean, and the elastic standard deviation Estd value. The correlations between SWE color image features and elastic modulus and age, lesion echogenicity, lesion maximum diameter, distance from the nipple, distance from the pectoralis major, pathological changes and BI-RADS classification were analyzed. Results: The biopsy rates of lesions were 59.1%, 27.0% and 13.0%, respectively, according to the characteristics of the color image and the E_ (max) modulus of elasticity of SWE. E_ (max) and SWE color image characteristics were significantly correlated with the maximum diameter of lesions (P <0.05). There was a significant correlation between E_ (max) and the distance from the pectoralis major to the lesion (P <0.05). Conclusion: SWE can significantly reduce the biopsy rate of breast fibroadenoma, the maximum diameter of the lesion and the distance from the pectoralis major is an important factor affecting the SWE imaging of fibroadenoma.