|
|
|
| Diagnostic value of conventional ultrasound combined with elastography in idiopathic granulomatous mastitis and ductal carcinoma in situ#br# |
| XING Boyuan1 ZHANG Bingyi1 LIU Jie1 YAN Ziwei1 DONG Meng1 LI Xingzi2 |
1.Department of Ultrasound, the First People’s Hospital of Yichang, Hubei Province, Yichang 443000, China;
2.Department of Pathology, the First People’s Hospital of Yichang, Hubei Province, Yichang 443000, China |
|
|
|
Abstract Objective To investigate the conventional ultrasonographic features and elastic characteristics of idiopathic granulomatous mastitis (IGM) and ductal carcinoma in situ (DCIS), in order to improve the differential diagnosis level of IGM and DCIS by ultrasonography. Methods IGM patients who underwent conventional ultrasound and elastography examination and were confirmed by hollow needle biopsy or surgical pathology in the Department of Ultrasound, the First People’s Hospital of Yichang, Hubei Province from January 2018 to July 2021 were selected as IGM group (45 cases), and DCIS patients as DCIS group (56 cases). The clinical characteristics, ultrasonic imaging characteristics, and ultrasonic elastic parameters of two groups were compared; receiver operating characteristic curve was drawn to calculate the sensitivity, specificity and optimal cut-off value of elastic ratio in diagnosis of IGM. Results There were statistically significant differences in age and maximum diameter of lesions between two groups (P < 0.05). There were statistically significant differences in internal echo, posterior echo characteristics, microcalcification, surrounding tissue edema, ipsilateral axillary lymph node enlargement, and elastic score between two groups (P < 0.05). The elastic ratio in IGM group was lower than that in DCIS group, and the difference was statistically significant (P < 0.05). The optimal cut-off value of elastic ratio for IGM diagnosis was 2.27, the sensitivity and specificity were 86.70% and 94.60%, respectively, and the area under the curve was 0.818 (95%CI: 0.706-0.929, P < 0.05). Conclusion Conventional ultrasound combined with elastography is helpful for the differential diagnosis of IGM and DCIS.
|
|
|
|
|
|
[1] 孙岩峰，王永，李玉胜，等.特发性肉芽肿性乳腺炎的诊疗进展[J].中华乳腺病杂志：电子版，2017，11（6）：372-374.
[2] D’Orsi CJ，Sickles EA，Mendelson EB，et al. ACR BI-RADS atlas，breast imaging reporting and data system [M]. 5th ed. Reston：American College of Radiology，2013：123-132.
[3] 陈欣，肖晓云，吴欢，等.微细血流成像技术在乳腺肿瘤鉴别中的应用[J].中国超声医学杂志，2016，32（5）：407-410.
[4] 罗葆明，杨海云，肖晓云，等.改良弹性评分标准在乳腺良恶性病灶鉴别诊断中的前瞻性研究[J].中华超声影像学杂志，2009，18（6）：514-516.
[5] Fereshte S，Hamidreza N，Masoumeh G，et al. Idiopathic granulomatous mastitis：Long-discussed but yet-to-be-known [J]. Autoimmunity，2016，49（4）：236-239.
[6] 邓苗，周荟，周子婷，等.肉芽肿性乳腺炎的诊治进展[J].医学理论与实践，2018，31（20）：3030-3032.
[7] 鲁嘉，刘赫，姜玉新，等.肉芽肿性乳腺炎的超声表现及临床、病理分析[J].中国医学影像技术，2011，27（11）：2246-2249.
[8] Sripami S，Ayachit A，Bala A，et al. Idiopatic granulomatous mastitis：a diagnostic dilemma for the breast radioIogist [J]. Insights Imaging，2016，7（4）：523-529.
[9] 王心怡，张楠，秦王燕，等.乳腺导管原位癌及浸润癌超声表现与病理相关性新探[J].中国超声医学杂志，2017， 33（6）：498-500.
[10] Badve SS，Gkmen-polar Y. Ductal carcinoma in situ of breast：update 2019 [J]. Pathology，2019，51（6）：563-569.
[11] Bae JS，Chang JM，Lee SH，et al. Prediction of invasive breast cancer using shear-wave elastography in patients with biopsy-confirmed ductal carcinoma in situ [J]. European radiology，2017，27（1）：7-15.
[12] Osako T，Takahashi K，Iwase T，et al. Diagnostic ultrasonography and mammography for invasive and noninvasive breast cancer in women aged 30 to 39 years [J]. Breast Cancer，2007，14（2）：229-233.
[13] 刘恒，张宏伟，丁松涛，等.肉芽肿性乳腺炎的临床特征分析[J].中国全科医学，2016，19（18）：2216-2218.
[14] Yilmaz E，Lebe B，Usal C，et al. Mammographic and sonographic findings in the diagnosis of idiopathic granulomatous mastitis [J]. Eur Radiol，2001，11（11）：2236-2240.
[15] Helal TEA，Shash LS，El-din SAS，et al. Idiopathic granulomatous mastitis：cytologic and histologic study of 65 Egyptian patients [J]. Acta Cytologica，2016，60（5）：438-444.
[16] 余蓉，李胜利，陈琮瑛，等.钙化和无钙化乳腺导管原位癌超声及组织病理学特征差异分析[J].中华超声影像学杂志，2016，25（6）：506-509.
[17] Park JS，Park YM，Kim EK，et al. Sonographic findings of high-grade and non-high-grade ductal carcinoma in situ of the breast [J]. J Ultrasound Med，2010，29（12）：1687-1697.
[18] 肖方星，申九妹，王静，等.141例肉芽肿性小叶性乳腺炎临床病理分析[J].中外医学研究，2021，19（5）：84-86.
[19] 熊淑红，肖琼，阮玖根，等.磁共振动态增强扫描联合扩散加权成像定量分析在乳腺导管原位癌伴微浸润中的诊断价值[J].中国当代医药，2021，28（28）：137-140.
[20] 黄春旺，裴书芳，王银，等.常规超声联合实时组织弹性成像对特发性肉芽肿性乳腺炎的诊断价值分析[J].中国全科医学，2014，17（30）：3649-3651.
[21] 史宪全，李俊来.超声弹性成像技术诊断乳腺疾病的研究进展[J].中华医学超声杂志：电子版，2013，10（3）：178-181.
[22] 姚春，陈林丽，李艳萍，等.超声影像学检查在肉芽肿性乳腺炎和浸润性导管癌鉴别诊断中的价值[J].中华肿瘤杂志，2018，40（3）：222-226.
[23] Teke M，Teke F，Alan B，et al. Differential diagnosis of idiopathic granulomatous mastitis and breast cancer using acoustic radiation force impulse imaging [J]. J Med Ultrason，2017，44（1）：109-115.
[24] Ya■ci B，Erdem TI，?覶eki?觭 B，et al. Differentiation between idiopathic granulomatous mastitis and malignant breast lesions using strain ratio on ultrasonic elastography [J]. Diagn Interv Imaging，2017，98（10）：685-691.
[25] 李伟伟，丛阳，刘琳，等.超声对乳腺导管原位癌中钙化的初步研究[J].中国超声医学杂志，2018，34（6）：495-497.
[26] Yoon JH，Jung HK，Lee JT，et al. Shear-wave elastography in the diagnosis of solid breast masses：what leads to false-negative or false-positive results? [J]. Eur Radiol，2013，23（9）：2432-2440.
[27] 王慧，周文斌，孙重期.应变式弹性成像联合超声造影在乳腺导管原位癌诊断中的应用价值[J].临床肿瘤学杂志，2018，23（12）：1123-1127. |
|
|
|
