超声弹性成像对乳腺良恶性结节的鉴别诊断价值  

Value of ultrasound elastography in differential diagnosis of benign and malignant breast nodules

作　　者：郭丽娟[1] 周文艳 曾丽华[2] GUO Lijuan;ZHOU Wenyan;ZENG Lihua(Department of Ultrasonography, the First Affiliated Hospital of Xinxiang Medical University, Xinxiang 453100, He＇ nan, China;Department of Radiation Medicine, the Fourth Military Medical University, Xi＇an 710032, Shaanxi, China)

机构地区：[1]新乡医学院第一附属医院超声科,河南新乡453100 [2]第四军医大学军事预防医学系放射医学教研室,西安7100320

出　　处：《癌症进展》2017年第8期900-902,922,共4页Oncology Progress

摘　　要：目的探讨超声弹性成像对乳腺良恶性结节的鉴别诊断价值。方法选择200例乳腺结节患者为研究对象,均接受超声弹性成像检查,以手术病理结果为金标准,分析超声成像应变率(SR)比值及超声等级评分对乳腺结节的诊断价值。结果 200例乳腺结节患者中,经手术病理证实恶性62例,良性138例。乳腺良恶性病变的SR比值分别为(2.71±0.65)和(0.98±0.16),差异有统计学意义(P﹤0.05)。以手术病理结果为金标准,超声等级评分诊断准确185例,诊断错误15例。超声成像SR比值及超声等级评分对乳腺占位性病变诊断的受试者工作特征(ROC)曲线下面积分别为0.940(95%CI:0.088~0.996)和0.938(95%CI:0.088~0.994)。超声成像SR比值及超声等级评分对乳腺占位性病变诊断的敏感度、特异度、阳性预测值、阴性预测值及诊断符合率分别为90.3%、93.5%、86.2%、95.6%、92.5%和91.9%、92.8%、85.1%、96.2%、92.5%。结论在乳腺良恶性结节的鉴别诊断中,超声成像SR比值及超声等级评分具有较高的诊断效力,值得临床推广应用。Objective To investigate the value of ultrasound elastography in differential diagnosis of benign and malignant breast nodules. Method 200 patients with breast nodules were included in the study, and were examined with ultrasound elastography, the diagnostic value of SR ratio and ultrasound grading in breast nodules were analyzed with surgical pathologic findings as golden standard. Result Among 200 patients with breast nodules, there were 62 cases of surgically confirmed malignant nodules and 138 cases of benign ones, of which the ratio of SR were（2.71±0.65） and（0.98±0.16）, respectively（P〈0.05）. Based on the results of surgical pathology, ultrasonic grading was correct in 185 cases, and was inconsistent in 15 cases. The area of ROC curve of SR and ultrasound grading in diagnosing breast space-occupying lesions was 0.940（95% CI： 0.088-0.996） and 0.938（95% CI： 0.088-0.994）, respectively, and the diagnostic sensitivity,specificity, positive predictive value, negative predictive value and diagnostic accuracy of SR and ultrasound grading score were 90.3%, 93.5%, 86.2%, 95.6%, 92.5% and 91.9%, 92.8%, 85.1%, 96.2%, 92.5%. Conclusion In the differential diagnosis of benign and malignant breast nodules, the SR and grading score of ultrasound elastography is of high diagnostic value, and its clinical applicable.

关 键 词：超声 弹性成像 乳腺肿瘤 应变率 

分 类 号：R737.9[医药卫生—肿瘤]