摘要
目的分析常规超声和弹性成像技术(UE)在非肿块型乳腺病变中的诊断价值。方法回顾性选取2018年5月至2019年10月金华市中心医院乳腺外科收治的78例非肿块型乳腺病变患者的常规超声及弹性超声图像,计算弹性应变比值,以组织学活检或术后病理结果作为金标准,评估弹性超声成像技术在鉴别诊断非肿块型乳腺病变良恶性的诊断效能。结果78例患者中,恶性病变44例,病理分型:导管浸润癌23例,导管内癌11例,黏液癌7例,浸润性小叶癌3例;良性病变34例,病理分型:乳腺增生14例,炎症10例,纤维腺瘤5例,腺病3例,导管内乳头状瘤2例。利用超声弹性成像应变率比值法(SR)诊断乳腺恶性病变45例(35例与病理结果相符),良性病变33例(24例与病理结果相符);常规超声诊断乳腺恶性病变39例(24例与病理结果相符),良性病变39例(19例与病理结果相符)。SR法对非肿块型乳腺病变的诊断准确性为75.64%,敏感度为79.55%,特异度为70.59%,阳性预测值为77.78%,阴性预测值为72.73%,常规超声检查对非肿块型乳腺病变的诊断准确性为55.13%,敏感度为54.55%,特异度为55.89%,阳性预测值为61.53%,阴性预测值为48.72%。SR法在鉴别非肿块型乳腺病变良恶性中差异有统计学意义(P<0.05)。结论UE在判断非肿块型乳腺病变良恶性中具有一定的临床应用价值。
Objective To compare and analyze the diagnostic value of conventional ultrasound and ultrasound elastography(UE)in non-mass breast lesions.Methods The conventional ultrasound and ultrasound elastography of 78 patients with non-mass breast lesions admitted to the Department of Breast Surgery in Jinhua Central Hospital from May 2018 to October 2019 were retrospectively selected.The elastic strain ratio was calculated.The diagnostic efficacy of elastography imaging technology in the differential diagnosis of non-mass breast lesions from benign and malignant was evaluated,using histological biopsy or postoperative pathological results as the gold standard.Results Among 78 patients,44 were malignant Among them,23 were invasive ductal carcinoma,11 were intraductal carcinoma,7 were mucinous carcinoma,and 3 were invasive lobular carcinoma;Among the 34 benign lesions,14 were breast hyperplasia,10 were inflammatory diseases,5 were fibroadenoma,3 were adenopathy,and 2 were intraductal papilloma.The strain ratio(SR)of ultrasonic elastography was used to diagnose malignant breast lesions in 45 cases(35 cases were consistent with the pathological results),benign lesions in 33 cases(24 cases were consistent with the pathological results).The conventional ultrasound diagnosed malignant breast lesions in 39 cases(24 cases were consistent with the pathological results),benign lesions in 39 cases(19 cases were consistent with the pathological results).The diagnostic accuracy of SR method for non-mass breast lesions was 75.64%,the sensitivity was 79.55%,the specificity was 70.59%,the positive predictive value was 77.78%,and the negative predictive value was 72.73%.The diagnostic accuracy of routine ultrasound for non-mass breast lesions was 55.13%,the sensitivity was 54.55%,the specificity was 55.89%,the positive predictive value was 61.53%,and the negative predictive value was 48.72%.SR method was statistically significant in distinguishing benign and malignant non-mass breast lesions(P<0.05).Conclusion UE has certain clinical application value in judging benign and malignant non-mass breast lesions.
作者
商瑞苗
杨道玲
孔敏刚
SHANG Ruimiao;YANG Daoling;KONG Min′gang(Department of Ultrasound Medicine,Jinhua Central Hospital,Jinhua 321000,China)
出处
《中国现代医生》
2021年第32期130-132,136,共4页
China Modern Doctor
基金
浙江省医药卫生科技计划项目(2020KY1012)。
