超声弹性成像联合超声BIRADS分级在乳腺癌诊断中的应用价值  

Application value of ultrasound elastography combined ultrasound and breast BIRADS classification in the diagnosis of breast cancer

作　　者：赵利萍 陈双和 李丽琴[2] 武向梅[3] 

机构地区：[1]浙江省绍兴市上虞人民医院超声科,浙江绍兴312300 [2]浙江省湖州市中心医院中心实验室,浙江湖州313000 [3]重庆医科大学分子医学与肿瘤研究中心,重庆400016

出　　处：《中国现代医生》2015年第10期109-112,116,F0003,共6页China Modern Doctor

基　　金：重庆市第三批科技项目计划(cstc2011jj A10035)

摘　　要：目的探讨超声弹性成像联合超声BIRADS分级在乳腺癌诊断中的应用价值。方法选择146例乳腺肿块患者,采用超声弹性成像进行乳腺检查,以病理结果为金标准,分别采用弹性应变量率比值、弹性成像评分、BIRADS分级及联合进行对乳腺肿块良恶性进行评价,比较不同诊断方法的诊断价值。结果弹性应变量率比值诊断乳腺癌灵敏度为83.54%,特异度为89.89%,准确度为86.90%;弹性成像评分诊断乳腺癌灵敏度为87.34%,特异度为92.26%,准确度为92.86%;BIRADS分级诊断乳腺癌灵敏度为88.61%,特异度为92.13%,准确度为90.48%;二联1法诊断乳腺癌灵敏度为92.41%,特异度为93.26%,准确度为92.86%;二联2法诊断乳腺癌灵敏度为89.87%,特异度为92.13%,准确度为91.07%;二联3法诊断乳腺癌灵敏度为93.67%,特异度为93.26%,准确度为93.45%;三联法诊断乳腺癌灵敏度为96.63%,特异度为95.51%,准确度为95.83%。二联1法、二联3法及三联灵敏度提高,三联法特异度和准确率明显提高(P<0.05)。三联Youden指数和Kappa值均最高,其次为二联3法。结论超声弹性成像的评价方法和超声BIRADS分级在乳腺癌的诊断中都有一定局限性,其中二联法评价可以一定程度提高灵敏度,但只有将弹性应变量率比值、弹性成像评分、BIRADS分级及三联进行评价时可明显提供灵敏度、特异度、准确度、Youden指数和Kappa值,具有较高的应用价值。Objective To evaluate application value of ultrasound elastography combined ultrasound and breast BIRADS classification in the diagnosis of breast cancer. Methods A total of 146 cases of breast lumps were treated with ultrasound elastography breast examination to pathological results as the gold standard,respectively elastic strain rate ratio, elastography score, BIRADS classification and joint benign and malignant breast masses were evaluated to compare diagnostic value of different diagnostic methods. Results The ratio of elastic strain rate of breast cancer diagnosis sensitivity,specificity and accuracy were 83.54%,89.89%,86.90%; elastography score diagnosis of breast cancer sensitivity,specificity and accuracy were 87.34%,92.26%,92.86%; BIRADS classification of breast cancer diagnostic sensitivity, specificity and accuracy were 88.61%,92.13%,90.48%; NO.1 two-linking diagnosis of breast cancer sensitivity,specificity and accuracy were 92.41%,93.26%,92.86%;NO.2 two-linking diagnosis of breast cancer sensitivity,specificity and accuracy were 89.87%,92.13%,91.07%;NO.3 two-linking bivalent three diagnostic sensitivity,specificity and accuracy were 93.67%,93.26%,93.45%;triple diagnosis of breast cancer sensitivity, specificity and accuracy were 96.63%,95.51%,95.83%. Bivalent a law,two French and three triple-linked increase in sensitivity,specificity and accuracy triple law had improved significantly（P〈0 . 05）. Triple Youden index and Kappa values were the highest,followed by two 3-linking method. Conclusion Ultrasound elastography and ultrasound BIRADS evaluation methods in the diagnosis of breast cancer classification has certain limitations, including two joint evaluation method can improve the sensitivity to a certain extent, but only the elastic strain rate ratio, elastography score,BIRADS classification can provide significant time and triple evaluate the sensitivity,specificity,accuracy,Youden index and Kappa values,has a high value.

关 键 词：乳腺癌 超声检查 弹性成像技术 超声 BIRADS分级 

分 类 号：R445.1[医药卫生—影像医学与核医学] R737.9[医药卫生—诊断学]