弹性定量参数对触诊阴性乳腺病灶的诊断价值  

Value of elastic quantitative parameters in diagnosis of non-palpable breast lesions

作　　者：姚丽华[1] 项金莲[1] 盛宇伟[2] 李小强[3] 张姝嫔[1] 程成 杨忱[1] 贾丽琼[1] 

机构地区：[1]上海市第一人民医院宝山分院超声科,200940 [2]上海市第一人民医院宝山分院外科,200940 [3]上海市第一人民医院宝山分院病理科,200940

出　　处：《临床超声医学杂志》2017年第10期670-673,共4页Journal of Clinical Ultrasound in Medicine

基　　金：上海市宝山区科技发展基金项目(12-E-7)

摘　　要：目的探讨弹性定量参数应变率(SR)比值、直径变化率及面积比对临床触诊阴性乳腺病灶(non-palpable breast lesions,NPBL)的诊断价值。方法选取150例经超声检查和手术病理证实的NPBL患者,根据术后病理结果分为良性病灶组(A组,n=110)和恶性病灶组(B组,n=40),比较两组SR比值、直径变化率及面积比。应用ROC曲线分析SR比值、直径变化率、面积比及其联合诊断乳腺恶性病灶的ROC曲线下面积、临界值、敏感性及特异性,并对其进行比较。结果 B组SR比值(6.04±2.53)显著高于A组(2.86±1.51),差异有统计学意义(t=5.031,P=0.000),常规超声与弹性成像测得A组病灶的直径和面积差异均无统计学意义,而弹性成像测得B组病灶的直径与面积均显著高于常规超声测值,差异均有统计学意义(P=0.000、0.016)。B组病灶的直径变化率显著高于A组(P=0.000),面积比亦显著高于A组(P=0.025)。应用SR比值、直径变化率及面积比联合诊断乳腺恶性病灶的敏感性为77.5%,特异性为94.5%,曲线下面积为0.937,高于SR比值、直径变化率及面积比单独诊断的效能。结论弹性定量参数SR比值、直径变化率及面积比在NPBL良恶性鉴别中均有效,而其联合诊断能够显著提高对乳腺病灶良恶性的鉴别能力。Objective To investigate the value of elastic quantitative parameters[strain rate(SR) ratio,diameter change rate and area ratio]in diagnosis of non-palpable breast lesions.Methods One hundred and fifty patients with non-palpable breast lesions confirmed by pathology were recruited and divided into benign lesions group(group A,n =110) and malignant lesions group(group B,n=40)according to postsurgical-pathology.Data of the SR ratio,diameter change rate and area ratio were compared and analyzed between two groups.The area under the curve(AUC),diagnostic threshold,sensitivity and specificity for breast lesions were evaluated by ROC curves.Results SR ratio of group B(6.04±2.53)was significantly higher than that in group A(2.86±1.51),there was significant difference(t=5.031,P=0.000).Compared the data detected by elastography with the data measured by two-dimensional ultrasound,there were no significant differences in diameter and the area in group A,while the significant differences in diameter and the area in group B were found(P=0.000,0.016).Compared with group A,the diameter change rate and the area ratio were significantly higher than those in group B(P=0.000,0.025).The sensitivity,specificity and AUC were 77.5%,94.5% and 0.937,respectively.Combined SR ratio,diameter change rate and area ratio showed a better ability in diagnosis of breast malignant lesions than use these indicators individually.Conclusion The combination of SR ratio,diameter change rate and area ratio is helpful to identify benign and malignant breast non-palpable breast lesions.

关 键 词：超声检查 弹性定量参数 触诊阴性乳腺病灶 

分 类 号：R737.9[医药卫生—肿瘤] R445.1[医药卫生—临床医学]