The diagnostic value of ultrasound BI-RADS combined with elasticity scoring and strain ratio in assessment of breast lesions

ZHENG Meijuan; XUE Ensheng; LIN Zhenhu; YE Qin; LIANG Rongxi

doi:10.19732/j.cnki.2096-6210.2020.05.003

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The diagnostic value of ultrasound BI-RADS combined with elasticity scoring and strain ratio in assessment of breast lesions

更新时间：2025-12-15

- The diagnostic value of ultrasound BI-RADS combined with elasticity scoring and strain ratio in assessment of breast lesions
- Vol. 29, Issue 5, Pages: 436-441(2020)
- 作者机构：
- 作者简介：
- 基金信息：
- DOI：10.19732/j.cnki.2096-6210.2020.05.003
  CLC：
- Published Online：28 October 2020，
  
  Published：28 October 2020
- 稿件说明：
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郑梅娟,薛恩生,林振湖,等. BI-RADS联合弹性评分及弹性应变率比值对乳腺病灶的诊断价值[J]. 肿瘤影像学, 2020, 29(5): 436-441 https://doi.

org/10.19732/j.cnki.2096-6210.2020.05.003
郑梅娟,薛恩生,林振湖,等. BI-RADS联合弹性评分及弹性应变率比值对乳腺病灶的诊断价值[J]. 肿瘤影像学, 2020, 29(5): 436-441 https://doi. DOI： 10.19732/j.cnki.2096-6210.2020.05.003.

org/10.19732/j.cnki.2096-6210.2020.05.003 DOI：

摘要

目的：

对比弹性评分及弹性应变率比值（strain ratio，SR）两种方法的诊断效能，并探讨应变弹性成像（strain elastography，SE）对乳腺病灶乳腺影像报告和数据系统（Breast Imaging Reporting and Data System，BI-RADS）分类的辅助价值。

方法：

收集199例乳腺肿块患者，行常规超声检查及SE。以病理学检查结果为金标准，构建受试者工作特征（receiver operating characteristic，ROC）曲线，比较两种弹性评估法的诊断效能，并比较BI-RADS分类与其联合SE的诊断价值。

结果：

SR和评分法ROC曲线的曲线下面积（area under curve，AUC）分别为0.897和0.796（

=0.017）。SR最佳诊断界值为4.03，诊断准确率为87.44%，评分法的最佳诊断界值为3分到4分之间，诊断准确率70.35%（

＜0.001）。对于3分病灶，评分法的诊断准确率（40.28%）显著小于SR（83.33%，

＜0.001），对于1~2分、4~5分病灶，两种方法诊断准确率差异无统计学意义。BI-RADS分类联合SE的诊断灵敏度、特异度、准确率、阳性预测值和阴性预测值分别为99.24%、73.53%、90.45%、87.84%和98.04%。

结论：

弹性评分法可用作初步判断乳腺病灶硬度信息的方法，当评分为3分时，需测量SR才能起到较好的辅助诊断作用，BI-RADS分类联合SE，有助于乳腺良恶性病灶的鉴别诊断，减少不必要的穿刺活检。

Abstract

Objective:

To compare the diagnostic efficacy of 5-point elasticity scoring and strain ratio (SR)

and to explore the value of strain elastography (SE) combined with Breast Imaging Reporting and Data System (BI-RADS) category in differentiating breast lesions.

Methods:

A total of 199 cases of breast lesions were examined with conventional ultrasound and SE

then 5-point elasticity scoring were recorded and SR were calculated. Based on the pathological results as the gold standard

the receiver operating characteristic (ROC) curve were used to compare the diagnostic efficiency. The diagnostic performance was compared between BI-RADS category and SE combined with BI-RADS category.

Results:

The area under curve (AUC) of ROC curve of SR and 5-point method were 0.897 and 0.796 respectively (

=0.017). The optimal diagnostic threshold of the SR was 4.03 and the diagnostic accuracy was 87.44%

and the optimal diagnostic threshold of the 5-point method was 3 to 4 point and the diagnostic accuracy was 70.35% (

＜0.001). For 3-point lesions

the diagnostic accuracy of the 5-point method was 40.28% significantly less than that of the SR (83.33%

＜0.001). For 1-2 point and 4-5 point lesions

there was no significant difference in the diagnostic accuracy between the two methods. The diagnostic sensitivity

specificity

accuracy

positive predictive value and negative predictive value of SE combined with BI-RADS were 99.24%

73.53%

90.45%

87.84% and 98.04%

respectively.

Conclusion:

Five-point method can be used as a preliminary method to evaluate the stiffness information of breast lesions. When the score is 3 points

measurement of SR isneeded to further auxiliary diagnosis. BI-RADS category combined with SE is helpful to the differentiation of benign and malignant breast lesions and to reduce some unnecessary puncture biopsy.

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