CAJ | 학술논문

目的：分析常规超声、钼靶X线摄影、超声弹性成像和常规超声+超声弹性成像对触诊阴性乳腺病灶的诊断价值，以提高早期乳腺癌的检出率。方法对触诊阴性乳腺病灶的238例患者（266个肿块，其中恶性79个肿块、良性187个肿块）的术前常规超声、钼靶X线摄影、超声弹性成像和超声+超声弹性成像的诊断结果进行分析，并与术后病理结果作对照。结果钼靶X线摄影的敏感性、特异性和准确性分别为79.8%、75.9%和77.1%；常规超声的敏感性、特异性和准确性分别为77.2%、86.1%和83.5%；超声弹性成像的敏感性、特异性和准确性分别为82.3%、87.2%和85.7%；超声+弹性成像敏感性、特异性和准确性分别为92.4%、93%和92.9%。敏感性：超声+超声弹性成像均高于常规超声、钼靶X线摄影和超声弹性成像（均P＜0.05）；常规超声、钼靶X线摄影和超声弹性成像的敏感性比较差异无统计学意义（均P＞0.05）。特异性及准确性：超声、超声弹性成像均高于钼靶X线摄影（均P＜0.05）；超声+超声弹性成像均高于常规超声、钼靶X线摄影和超声弹性成像（均P＜0.05）；超声与超声弹性成像比较差异无统计学意义（P＞0.05）。结论常规超声无创、可重复性强，敏感性及特异性较高，可作为检查乳腺疾病的首选检查手段；钼靶X线摄影发现微小钙化优势显著；超声弹性成像有助于提高超声乳腺检查的准确性。超声联合弹性成像的综合应用，是评估触诊阴性乳腺病灶良、恶性的新方法，可提高早期乳腺癌的检出率。
목적：분석상규초성、목파X선섭영、초성탄성성상화상규초성+초성탄성성상대촉진음성유선병조적진단개치，이제고조기유선암적검출솔。방법대촉진음성유선병조적238례환자（266개종괴，기중악성79개종괴、량성187개종괴）적술전상규초성、목파X선섭영、초성탄성성상화초성+초성탄성성상적진단결과진행분석，병여술후병리결과작대조。결과목파X선섭영적민감성、특이성화준학성분별위79.8%、75.9%화77.1%；상규초성적민감성、특이성화준학성분별위77.2%、86.1%화83.5%；초성탄성성상적민감성、특이성화준학성분별위82.3%、87.2%화85.7%；초성+탄성성상민감성、특이성화준학성분별위92.4%、93%화92.9%。민감성：초성+초성탄성성상균고우상규초성、목파X선섭영화초성탄성성상（균P＜0.05）；상규초성、목파X선섭영화초성탄성성상적민감성비교차이무통계학의의（균P＞0.05）。특이성급준학성：초성、초성탄성성상균고우목파X선섭영（균P＜0.05）；초성+초성탄성성상균고우상규초성、목파X선섭영화초성탄성성상（균P＜0.05）；초성여초성탄성성상비교차이무통계학의의（P＞0.05）。결론상규초성무창、가중복성강，민감성급특이성교고，가작위검사유선질병적수선검사수단；목파X선섭영발현미소개화우세현저；초성탄성성상유조우제고초성유선검사적준학성。초성연합탄성성상적종합응용，시평고촉진음성유선병조량、악성적신방법，가제고조기유선암적검출솔。
Objective To analyze the diagnostic values of conventional ultrasound, mammography and ultrasound combined with elasticity in nonpalpable breast lesions, and to improve the detection rate of early breast cancer. Methods Results of conventional ultrasound, mammography and ultrasound combined with elasticity were analyzed and compared with histopathologic findings in 238 patients with nonpalpable breast lesions (266 lumps, including 79 malignant lumps and 187 benign lumps). Results The sensitivity,specificity and accuracy were, respectively, 79.8%, 75.9% and 77.1% for mammography, 77.2%, 86.1% and 83.5% for conventional ultrasound, 82.3%, 87.2% and 85.7% for elastography, and 92.4%, 93%and 92.9%for ultrasound combined with elasticity. The ultrasound combined with elasticity had higher sensitivity, specificity and accuracy than conventional ultrasound, mammography and elastography (P<0.05).However,there were no significant differences in the sensitivity among conve-ntional ultrasound, mammography and elastography, as well as in the specificity and accuracy between conventional ultrasound and elastography(P>0.05).The specificity and accuracy of conventional ultraso-und or elastography were significantly higher than those of mammography (P<0.05).Conclusion Ultras-ound can be used as the preferred means of examination of mammary gland disease due to noninvasion and high repeatability, sensitivity and specificity. Mammography has significant advantage for finding microcalcification. Elastography can help to improve the accuracy of breast ultrasound examination. Integrated application of ultrasound and elastography is a new method for the assessment of benign and malignant nonpalpable breast lesions and can improve the detection rate of early breast cancer.