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目的探索剪切波弹性成像(SWE)技术评估乳腺病变的优化方法学。方法对48例女性患者共51个病灶行SWE测定。(1)成像模式(标准模式,Sta;穿透力模式,Pen);(2)耦合剂用量(适量及足量),在两种情况下观察病灶的成像特征及各弹性参数。结果 (1)51个乳腺病灶在Sta模式下,39个出现彩色充盈不全;在Pen模式、足量耦合剂条件下仅3个病灶出现彩色充盈不全。(2)Pen模式、足量耦合剂条件下,20个病灶弹性图像伪像减少;适量较足量耦合剂扫查条件下所得弹性参数Emax、Emean、Esd(kPa)(P<0.05)偏大,两种条件下,弹性参数(Emax、Emean、Esd)鉴别良恶性病变ROC曲线下面积及截点不同。结论剪切波弹性成像评估乳腺病灶的方法学直接影响到定性、定量分析的结果,因此选择正确、规范化的操作方法至关重要。
Objective To explore the method of shear wave elastography (SWE) to evaluate the optimal method of breast lesions. Methods A total of 51 lesions in 48 female patients underwent SWE. (1) imaging mode (standard mode, Sta; penetration mode, Pen); (2) the amount of coupling agent (adequate and sufficient), in both cases observe the imaging characteristics of the lesion and the various elastic parameters. Results (1) In Sta mode, 51 lesions showed color insufficiency in 51 breast lesions. In Pen mode, only 3 lesions showed color insufficiency in the presence of sufficient coupling agent. (2) Pen mode, the elastic images of 20 lesions lessened under the condition of enough coupling agent; the elastic parameters Emax, Emean, Esd (kPa) (P <0.05) In both cases, the area under the ROC curve and the cut-off point were different between the Emax, Emean, and Esd parameters. Conclusion The method of shear wave elastography to evaluate breast lesions has a direct impact on the results of qualitative and quantitative analysis. Therefore, it is very important to select correct and standardized methods of operation.