弹性成像对超声引导乳腺肿块穿刺活检指导价值研究  

Elasticity imaging of breast lumps biopsy guided by ultrasound guidance value

作　　者：毕名森 曹军英[2] 张筠[2] 张岩[1] 孙钰[1] 韩涛[3] 郑振东[3] 

机构地区：[1]锦州医科大学沈阳军区总医院研究生培养基地,辽宁沈阳110016 [2]沈阳军区总医院超声科,辽宁沈阳110016 [3]沈阳军区总医院肿瘤科,辽宁沈阳110016

出　　处：《临床军医杂志》2017年第1期79-81,共3页Clinical Journal of Medical Officers

基　　金：中国博士后基金面上资助项目(2015M582822)

摘　　要：目的探讨超声弹性成像对超声引导BI-RADS 4级乳腺肿块穿刺活检的指导价值。方法回顾性分析141例经超声引导下BI-RADS 4级乳腺肿块穿刺活检患者的临床资料。所有患者穿刺前均进行常规超声及弹性成像检查,以BI-RADS分级及弹性评分评价乳腺肿块的良恶性。结果 BI-RADS分级为4a级的阴性预测值(NPV)为89.6%,弹性评分≤3分的NPV为95.5%,两者比较,差异无统计学意义(P>0.05);BI-RADS分级为4b级的阳性预测值(PPV)为59.3%,弹性评分≥4分的PPV为85.3%,两者比较,差异有统计学意义(P<0.05);BI-RADS分级为4c级的PPV为89.7%,弹性评分≥4分的PPV为96.9%,两者比较,差异无统计学意义(P>0.05);BI-RADS分级≥4b级的PPV为72.0%,弹性评分≥4分的PPV为90.9%,两者比较,差异有统计学意义(P<0.05)。结论弹性评分<3分的4a级乳腺肿块可以短期随访观察;弹性评分为5分的4c级乳腺肿块建议直接手术治疗;对于良恶性难以鉴别的4b级乳腺肿块,超声弹性成像可以进一步提高其PPV,建议穿刺活检明确诊断。Objective To investigate the value of elastography instructing ultrasound-guided BI-RADS4 breast lumps puncture. Methods A retrospective study was performed on 141 patients with breast lesions of BI-RADS4,the clinical data was analyzed,conventional ultrasound examination and elastography was performed before puncture. To evaluate breast lesions being benign or malignant by BIRADS classification and elastography score. Results NPV of 4a was 89. 6% and NPV of 4a with less than or equal to 3 score was95. 5%,there was no significant difference between them（ P〉0. 05）; PPV of 4b was 59. 3%,and PPV of 4b with more than or equal to 4 score was 85. 3% and the difference between them was statistically significant（ P〈0. 05）; PPV of 4c was 89. 7%,and PPV of 4c with more than or equal to 4 score was 96. 9%,and there was no significant difference between them（ P〉0. 05）; PPV of BI-RADS4 with more than or equal to 4 score was 90. 9%,which was significantly different from PPV of BI-RADS4 which was 72. 0%（ P〈0. 05）. Conclusion Patients of 4a with less than 3 score can be performed short-term follow-up; 4c with 5 score is suggested to be operated directly; for 4b that benign or malignant lesions cannot be separated easily,UE score can improve its PPV,which needs to be underwent puncture to make a definite diagnosis that the mass is benign or malignant.

关 键 词：超声 弹性成像 乳腺肿块 穿刺活检 

分 类 号：R655.8[医药卫生—外科学]