{"title":"Incremental Value of Shear Wave Elastography and Contrast-Enhanced Ultrasound in the Differential Diagnosis of Breast Non-Mass-Like Lesions.","authors":"Hui Li, Lixia Chen, Shihao Xu","doi":"10.2147/IJWH.S490565","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To analyse the parameters of shear wave elastography (SWE) and contrast-enhanced ultrasound (CEUS) in breast non-mass-like lesions (NMLs) and to evaluate the added diagnostic value of SWE and CEUS when combined with B-mode ultrasound (US) for differentiating NMLs.</p><p><strong>Methods: </strong>A total of 118 NMLs from 115 patients underwent US, SWE, and CEUS examinations. The SWE parameter with the highest areas under the receiver operating characteristic (ROC) curves (Az) and independent variables of CEUS obtained by logistic regression were used to adjust the BI-RADS-US (Breast Imaging Reporting and Data System for Ultrasound) classification. The adjusted BI-RADS risk stratification was then compared with the original classification. Additionally, the diagnostic effectiveness of US+SWE, US+CEUS, and US+SWE+CEUS combinations was calculated and compared.</p><p><strong>Results: </strong>The \"stiff rim sign\" was used as the optimal SWE indicator for BI-RADS adjustment. CEUS diagnostic criteria for adjustment included enhancement intensity, enhancement size, and the presence of radial or penetrating vessels. The Az values of US+SWE+CEUS and US+CEUS combinations were significantly higher than that of US alone (<i>P</i><0.05). However, there was no significant difference in the Az value of US+SWE and US (<i>P</i> = 0.072). US+SWE+CEUS combination showed significantly higher Az values compared to other combinations (<i>P</i><0.05), and achieved the highest sensitivity and specificity.</p><p><strong>Conclusion: </strong>Adding SWE and CEUS to conventional US enhances diagnostic accuracy for NMLs, offering a meaningful incremental value for BI-RADS classification in the assessment of NMLs.</p>","PeriodicalId":14356,"journal":{"name":"International Journal of Women's Health","volume":"16 ","pages":"2221-2230"},"PeriodicalIF":2.5000,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11668051/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Women's Health","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.2147/IJWH.S490565","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"OBSTETRICS & GYNECOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Objective: To analyse the parameters of shear wave elastography (SWE) and contrast-enhanced ultrasound (CEUS) in breast non-mass-like lesions (NMLs) and to evaluate the added diagnostic value of SWE and CEUS when combined with B-mode ultrasound (US) for differentiating NMLs.
Methods: A total of 118 NMLs from 115 patients underwent US, SWE, and CEUS examinations. The SWE parameter with the highest areas under the receiver operating characteristic (ROC) curves (Az) and independent variables of CEUS obtained by logistic regression were used to adjust the BI-RADS-US (Breast Imaging Reporting and Data System for Ultrasound) classification. The adjusted BI-RADS risk stratification was then compared with the original classification. Additionally, the diagnostic effectiveness of US+SWE, US+CEUS, and US+SWE+CEUS combinations was calculated and compared.
Results: The "stiff rim sign" was used as the optimal SWE indicator for BI-RADS adjustment. CEUS diagnostic criteria for adjustment included enhancement intensity, enhancement size, and the presence of radial or penetrating vessels. The Az values of US+SWE+CEUS and US+CEUS combinations were significantly higher than that of US alone (P<0.05). However, there was no significant difference in the Az value of US+SWE and US (P = 0.072). US+SWE+CEUS combination showed significantly higher Az values compared to other combinations (P<0.05), and achieved the highest sensitivity and specificity.
Conclusion: Adding SWE and CEUS to conventional US enhances diagnostic accuracy for NMLs, offering a meaningful incremental value for BI-RADS classification in the assessment of NMLs.
目的：分析剪切波弹性成像（SWE）和增强超声（CEUS）在乳腺非肿块样病变（NMLs）中的参数，并评价剪切波弹性成像（SWE）和增强超声（CEUS）联合b超（US）对NMLs的附加诊断价值。方法：115例患者共118例nml行US、SWE和CEUS检查。采用受试者工作特征曲线（ROC）下面积最大的SWE参数和逻辑回归得到的超声造影指标的自变量来调整BI-RADS-US （Breast Imaging Reporting and Data System for Ultrasound）分类。然后将调整后的BI-RADS风险分层与原始分类进行比较。此外，计算并比较US+SWE、US+CEUS和US+SWE+CEUS组合的诊断有效性。结果：“僵硬边缘标志”是BI-RADS调整的最佳SWE指标。超声造影调整的诊断标准包括增强强度、增强大小以及是否存在放射状或穿透性血管。US+SWE+CEUS和US+CEUS联合使用的Az值均显著高于US单独使用（PP = 0.072）。与其他组合相比，US+SWE+CEUS组合显示出更高的Az值(结论：在常规US基础上添加SWE和CEUS可提高nml的诊断准确性，为BI-RADS分类评估nml提供了有意义的增量价值。
期刊介绍：
International Journal of Women''s Health is an international, peer-reviewed, open access, online journal. Publishing original research, reports, editorials, reviews and commentaries on all aspects of women''s healthcare including gynecology, obstetrics, and breast cancer. Subject areas include: Chronic conditions including cancers of various organs specific and not specific to women Migraine, headaches, arthritis, osteoporosis Endocrine and autoimmune syndromes - asthma, multiple sclerosis, lupus, diabetes Sexual and reproductive health including fertility patterns and emerging technologies to address infertility Infectious disease with chronic sequelae including HIV/AIDS, HPV, PID, and other STDs Psychological and psychosocial conditions - depression across the life span, substance abuse, domestic violence Health maintenance among aging females - factors affecting the quality of life including physical, social and mental issues Avenues for health promotion and disease prevention across the life span Male vs female incidence comparisons for conditions that affect both genders.
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