乳腺肿块的超声弹性成像、多普勒超声及X线钼靶检查

Comparison of ultrasonic elastography, Doppler ultrasonography and mammography in breast diseases: corresponding to pathological diagnosis

目的探讨超声弹性成像、多普勒超声及X线钼靶成像对乳腺肿块的良恶性鉴别诊断价值。方法应用超声弹性成像、多普勒超声及X线钼靶成像对276例患者获手术病理证实的286个乳腺病灶进行检查。结果良性207例共215个病灶,恶性69例共71个病灶,超声弹性成像诊断恶性病变敏感性为88.7%,特异性为96.3%,准确性为94.4%;彩色多普勒血流显像诊断乳腺恶性肿瘤的敏感性为71.8%,特异性为73.5%,准确性为73.1%;脉冲多普勒血流显像诊断乳腺恶性肿瘤的敏感性为73.3%,特异性为58.0%,准确性为64.2%;X线钼靶成像诊断乳腺恶性肿瘤的敏感性为57.8%,特异性为87.4%,准确性为80.1%。结论超声弹性成像鉴别乳腺肿瘤良恶性的准确性较多普勒超声及X线钼靶成像高。

Objective To assess the value of ultrasonic elastography, Doppler ultrasonography and mammography in the differentiation of breast diseases. Methods 276 patients with 286 lesions confirmed by pathology in breast were examined by ultrasonic elastography （UE）, color Doppler flow imaging （CDFI）, pulsed Doppler ultrasonography （PDU） and mammography. Results Pathologically, there were 215 benign breast lesions in 207 patients and 71 malignant lesions in 69 patients. The sensibility, specificity and accuracy of CDFI for differentiation were 71.8 %, 73.5 % and 73.1%, respectively. Those of PDU for differentiation were 73.3%, 58.0% and 64.2%, respectively; and those of mammography, 57.8%, 87.4% and 80. 1%, respectively. The sensibility, specificity and accuracy of UE for differentiation were 88.7%, 96.3% and 94.4%, respectively. Conclusion The ability of ultrasonic elastography in the differentiation of breast tumor is much higher than mammography and Doppler ultrasonography.