华中科技大学学报（医学版）
華中科技大學學報（醫學版）
화중과기대학학보（의학판）
ACTA UNIVERSITATIS MEDICINAE TONGJI
2015年
1期
114-116,120
,共4页
超声弹性成像%常规超声%乳腺肿块%鉴别诊断
超聲彈性成像%常規超聲%乳腺腫塊%鑒彆診斷
초성탄성성상%상규초성%유선종괴%감별진단
ultrasound elastography%ultrasound%breast masses%differential diagnosis of benign and malignancy
目的：评价超声弹性成像（ultrasound elastography ，UE）对乳腺肿块良恶性的鉴别诊断价值。方法收集180例患有乳腺实性肿块女性患者的临床资料，对180个乳腺实性肿块分别进行术前常规超声（ultrasound ，US）和UE检查，对肿块的良恶性进行初步判断，以手术后组织病理结果作为标准，比较两种诊断方法的诊断符合率和ROC曲线特征值。结果 U E正确诊断出48例良性和127例恶性肿块，U S正确诊断出38例良性和112例恶性肿块，U E对乳腺肿块良恶性诊断的灵敏度、特异度、准确度、阳性预测值与阴性预测值均高于 US ，差异具有统计学意义（均 P＜0.05）；UE组的ROC曲线下面积AUC值为0.926，高于常规超声组的AUC值0.899，差异有统计学意义（Z＝2.8，P＜0.05）。结论UE在乳腺肿块良恶性的鉴别诊断中具有高灵敏度、特异度和准确度等特点，应用价值高，但尚存在一定缺陷，在应用UE诊断乳腺疾病时，应结合US综合评判。
目的：評價超聲彈性成像（ultrasound elastography ，UE）對乳腺腫塊良噁性的鑒彆診斷價值。方法收集180例患有乳腺實性腫塊女性患者的臨床資料，對180箇乳腺實性腫塊分彆進行術前常規超聲（ultrasound ，US）和UE檢查，對腫塊的良噁性進行初步判斷，以手術後組織病理結果作為標準，比較兩種診斷方法的診斷符閤率和ROC麯線特徵值。結果 U E正確診斷齣48例良性和127例噁性腫塊，U S正確診斷齣38例良性和112例噁性腫塊，U E對乳腺腫塊良噁性診斷的靈敏度、特異度、準確度、暘性預測值與陰性預測值均高于 US ，差異具有統計學意義（均 P＜0.05）；UE組的ROC麯線下麵積AUC值為0.926，高于常規超聲組的AUC值0.899，差異有統計學意義（Z＝2.8，P＜0.05）。結論UE在乳腺腫塊良噁性的鑒彆診斷中具有高靈敏度、特異度和準確度等特點，應用價值高，但尚存在一定缺陷，在應用UE診斷乳腺疾病時，應結閤US綜閤評判。
목적：평개초성탄성성상（ultrasound elastography ，UE）대유선종괴량악성적감별진단개치。방법수집180례환유유선실성종괴녀성환자적림상자료，대180개유선실성종괴분별진행술전상규초성（ultrasound ，US）화UE검사，대종괴적량악성진행초보판단，이수술후조직병리결과작위표준，비교량충진단방법적진단부합솔화ROC곡선특정치。결과 U E정학진단출48례량성화127례악성종괴，U S정학진단출38례량성화112례악성종괴，U E대유선종괴량악성진단적령민도、특이도、준학도、양성예측치여음성예측치균고우 US ，차이구유통계학의의（균 P＜0.05）；UE조적ROC곡선하면적AUC치위0.926，고우상규초성조적AUC치0.899，차이유통계학의의（Z＝2.8，P＜0.05）。결론UE재유선종괴량악성적감별진단중구유고령민도、특이도화준학도등특점，응용개치고，단상존재일정결함，재응용UE진단유선질병시，응결합US종합평판。
Objective To assess the value of ultrasound elastography (UE) in the differential diagnosis of benign and ma‐lignant breast masses.Methods Clinical data of 180 female patients with breast masses were collected. A total of 180 masses in these patients were detected by ultrasound (US) and UE to primarily identify the benign or malignant masses before surgery. The diagnostic coincidence rate and values of ROC curve were compared based on the postoperative pathologic results between the two diagnosis methods.Results Forty‐eight benign masses and 127 malignant masses were correctly diagnosed by UE ,and 38 benign masses and 112 malignant masses by US. The sensitivity ,specificity ,accuracy ,positive predictive value and negative predictive value were higher in UE group than in US group ,and there were significant statistical differences (P<0.05 for all). Furthermore ,the value of area under the ROC curve (AUC) in UE group was 0.926 ,significantly higher than that in US group (0.899) (Z=2.8 ,P<0.05).Conclusion UE has the advantages of high sensitivity ,specificity and accuracy in differential di‐agnosis of the nature of breast masses. In terms of some disadvantages of UE ,UE should be combined with US in the diagnosis of benign and malignant breast diseases.
