超声引导下穿刺活检鉴别病灶良恶性的价值探讨  

Value of ultrasound-guided biopsy in identification of benign or malignant masses

作　　者：尹莉[1] 梁晓宁[1] 于泽兴 卢瑞刚[1] 张颖[1] 巩丽焕[1] 曲鹏 郭瑞君[1] YIN Li;LIANG Xiaoning;YU Zexing;LU Ruigang;ZHANG Ying;GONG Lihuan;QU Peng;GUO Ruijun(Department of Ultrasound,Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China)

机构地区：[1]首都医科大学附属北京朝阳医院超声医学科,北京市100020

出　　处：《临床超声医学杂志》2018年第3期191-194,共4页Journal of Clinical Ultrasound in Medicine

摘　　要：目的探讨超声引导下穿刺活检(USGB)在病灶定性诊断中的价值。方法回顾性分析我院343例接受USGB肿物性质待查患者的临床及病理资料,计算其穿刺成功率、敏感性、特异性、误诊率、漏诊率、阳性预测值、阴性预测值、准确率、Youden指数、阳性似然比、阴性似然比及Kappa值。结果 343例患者共343个病灶,其中325个穿刺标本获得明确定性诊断,穿刺成功率94.75%。经术后病理证实,恶性202个,良性141个,USGB误诊10个,漏诊14个,准确率93.00%(319/343),敏感性、特异性、误诊率、漏诊率、阳性预测值、阴性预测值、Youden指数、阳性似然比及阴性似然比分别为93.07%(188/202)、92.91%(131/141)、7.09%(10/141)、6.93%(14/202)、94.95%(188/198)、90.34%(131/145)、85.98%,13.12及0.07。USGB与金标准比较总体一致性好(Kappa=0.86)。结论 USGB穿刺成功率高,诊断病灶良恶性准确率高,与金标准一致性好,对临床诊断及指导治疗有重要价值。Objective To explore the value of ultrasound-guided biopsy(USGB)in diagnosing benign or malignant masses.Methods The clinical and pathological dates were retrospectively analyzed from343patients who had underwent USGB for suspected malignant masses in our hospital.The success rate of USGB,sensitivity,specificity,misdiagnostic rate,missed diagnostic rate,positive predict value,negative predict value,Youden index(YI),positive likelihood rate,negative likelihood rate and Kappa value were calculated.Results A total of343lesions in343cases,325lesions were definitely diagnosed and the success rate of USGB was94.75%(325/343).Confirmed by postoperative pathology,202lesions were diagnosed as malignant and141as benign.10lesions were misdiagnosed,14lesions were missed diagnosed,and the accuracy was93.00%(319/343).The sensitivity,specificity,misdiagnostic rate,missed diagnostic rate,positive predict value,negative predict value,YI,positive likelihood rate and negative likelihood rate of USGB were93.07%(188/202),92.91%(131/141),7.09%(10/141),6.93%(14/202),94.95%(188/198),90.34%(31/145),85.98%,13.12and0.07,respectively.The consistency of USGB and gold standard was great(Kappa=0.86).Conclusion USGB has significant value in clinical diagnosis and guiding treatment,with high puncture success rate,high accuracy in diagnosis and great consistency with gold standard.

关 键 词：超声引导 介入性 病灶 活检 

分 类 号：R445.1[医药卫生—影像医学与核医学]