联合应用X线摄影和超声成像对乳腺微小病变的诊断价值

Diagnostic value of the combination of mammography and ultrasonography in non-papable breast lesions

目的评价和比较乳腺X线摄影、乳腺超声成像以及二者联合在乳腺微小疾病中的诊断价值。方法46个乳腺微小病变同时行乳腺X线和超声成像检查,根据怀疑乳腺病变的恶性程度,将术前X线检查、超声成像、两者联合将病变分为4级:I级-良性;II级-不能定性;III级-可能恶性;IV级-恶性。前瞻性记录3种方式的分级,并与病理诊断对照。结果46个乳腺微小病变中,良性35个,恶性11个。两者联合对乳腺微小病变诊断的敏感性为100%,特异性为94.3%,诊断准确率为95.7%。乳腺X线检查和超声成像的敏感性分别为90.9%和63.6%,特异性分别为91.4%和94.3%,诊断准确率分别为91.3%和87.0%。两者联合的各项指标均优于单纯采用乳腺X线检查和超声成像。

[Objective] To evaluate the accuracy of mammography, ultrasonogrphy and combination of both modalities in non-papable breasdesions. [Methods] A total of 46 patients with non-papable breast lesions was enwiled in this study. According to the grade of suspicion of malignancy by imaging manifestations, ever）, lesion was prospectively classified by mammography, sonography and combination of findings of both modalities into four categories as follows： category Ⅰ： benign, category Ⅱ： equivocal, category Ⅲ： probably malignant and category Ⅳ： malignant. The imaging classifications were correlated with pathology diagnosis. [Results] Out of the 46 breast lesions diagnosed pathology, 35 lesions were proved benign and 11 were malignant. The sensitivity, specificity, and accuracy of combination of the two modalities were 100%, 94.3%, 95.7%; The sensitivity, specificity, and accuracy of mammography, ultrasonography were 90.9% and 63.6%, 91.4% and 94.3%, 91.3% and 87% respectively. The every index of the two modahties had significant increase than that of each single modality. [Conclusion] A higher diagnostic value could be achieved by using combination of the two modality.