CAJ | 학술논문

【目的】探讨弹性超声成像在乳腺病灶不同深度中的诊断价值。【方法】收集拟行手术或穿刺活检需行术前检查的患者134例，采用弹性超声成像技术评估病灶，按病灶深度分为4组：D＜5 mm（Ⅰ组），5 mm≤D＜10 mm（Ⅱ组），10 mm≤D＜15 mm（Ⅲ组），D≥15 mm（Ⅳ组），以病理结果为金标准，采用Itoh评分法对鉴别乳腺实性病灶的良恶性，并计算弹性超声诊断不同深度乳腺实性病灶良恶性的敏感性、特异性、准确度、阳性预测值和阴性预测值。【结果】收集158个病灶，其中良性病变112个，恶性病变46个；曲线下面积（A U C ）为0．915；Ⅰ、Ⅱ、Ⅲ、Ⅳ组不同深度的敏感性、特异性、准确度、阳性预测值和阴性预测值随着深度增加准确率依次下降，但除特异性四组比较无差异（P ＞0．05）外，其他三组Ⅰ组显著高于Ⅳ组（P ＜0．05），Ⅱ组显著高于Ⅲ组（ P ＜0．05），Ⅰ组与Ⅱ组比较无差异（ P ＞0．05）。【结论】实时组织弹性成像的Itoh评分法对鉴别乳腺实性病灶的良恶性具有较高的诊断价值；但检查肿块的深度对检查结果的准确率具有一定影响。
【목적】탐토탄성초성성상재유선병조불동심도중적진단개치。【방법】수집의행수술혹천자활검수행술전검사적환자134례，채용탄성초성성상기술평고병조，안병조심도분위4조：D＜5 mm（Ⅰ조），5 mm≤D＜10 mm（Ⅱ조），10 mm≤D＜15 mm（Ⅲ조），D≥15 mm（Ⅳ조），이병리결과위금표준，채용Itoh평분법대감별유선실성병조적량악성，병계산탄성초성진단불동심도유선실성병조량악성적민감성、특이성、준학도、양성예측치화음성예측치。【결과】수집158개병조，기중량성병변112개，악성병변46개；곡선하면적（A U C ）위0．915；Ⅰ、Ⅱ、Ⅲ、Ⅳ조불동심도적민감성、특이성、준학도、양성예측치화음성예측치수착심도증가준학솔의차하강，단제특이성사조비교무차이（P ＞0．05）외，기타삼조Ⅰ조현저고우Ⅳ조（P ＜0．05），Ⅱ조현저고우Ⅲ조（ P ＜0．05），Ⅰ조여Ⅱ조비교무차이（ P ＞0．05）。【결론】실시조직탄성성상적Itoh평분법대감별유선실성병조적량악성구유교고적진단개치；단검사종괴적심도대검사결과적준학솔구유일정영향。
[Objective]To evaluate the value of ultrasonic elastography (UE) in the differentiation of benign and malignant breast lesions and estimate the impact of breast lesion depth on the diagnostic results of UE .[Methods]We performed UE on the female patients who will get an operation or core needle biopsy in the diagnosis of breast mass between April 2013 and October 2014 .Based on the method of Itoh et al ,the elasticity scores were compared with the pathology findings . According to the pathologic diagnoses , the receiver operating characteristic (ROC ) curves were used to evaluate the diagnostic value of UE in benign and malignant breast lesions as judged on the basis of AUC (area under ROC curve) .According to the depth of superior margin (D) of lesions ,the lesions were divided into four groups (D<5 mm ,5 mm ≤D<10 mm ,10 mm≤D<15 mm ,D ≥15 mm) .The sensitivity ,specificity , accuracy ,positive predictive value and negative predictive value were calculated .Andχ2 and Fischer's exact tests were used for analyzing non‐parametric variables .The differences of four groups were compared to assess the impact of breast lesion depth on the diagnostic results of UE .[Results]A total of 134 patients with 158 breast lesions were in‐cluded .Their mean age was 43 .4 ± 11 .6 years .There were 112 benign and 46 malignant lesions .The AUC was 0 .915 and it denoted a high accuracy of UE .The accuracies of four depths were different statistically at 97 .6% , 93 .7% ,84 .6% and 75 .9% respectively ( P<0 .05) .Furthermore ,statistical differences existed between groups D<5 mm and D≥15 mm ( P<0 .05) .Yet the other groups had no statistical differences .[Conclusion] The Itoh e‐lasticity score of UE is valuable in estimating breast lesions .And the depth of lesion has impact on the sensitivity and accuracy of breast examination .