超声弹性成像与钼靶X线成像对乳腺病灶临床诊断价值的比较

Ultrasonic elastography and molybdenum X-ray photography in differential diagnosis of breast diseases

目的：比较超声弹性成像（ultrasonic elastography，UE）与钼靶X线成像（molybdenum X-ray photography，MX-rP）对良、恶性乳腺病灶的鉴别诊断价值。方法：对83例女性患者共101个病灶术前行UE与MX-rP检查，以手术病理为诊断金标准，分析UE与MX-rP诊断乳腺疾病的准确性。结果：UE诊断乳腺恶性病变的敏感性、特异性、准确性、Youden指数、阳性和阴性预测值分别为87．06％，93．05％，91．08％，83．30％，94．36％和80．10％，阳性和阴性拟然比分别为12．41（95％CI，5．90-26．88）和0．14（95％CI，0．06～0．30）。MX-rP诊断乳腺恶性病变的敏感性、特异性、准确性、Youden指数阳性和阴性预测值分别为72．4％，83．33％，80．19％，87．74％，89．55％和63．52％，阳性和阴性拟然比分别为4．34（95％CI，1．63～11．42）和0．33（95％CI，0．19～0．63）。UE诊断准确性高于MX-rP（P=0．039）。UE诊断乳腺良恶性病灶的受试者特征曲线下面积为0．954（95％CI，0．912-0．996）。结论：UE在诊断乳房良恶性病灶时较MX-rP更有价值。

Objective To compare the accuracy of ultrasonic elastography （UE） with molybdenum X-ray photography （MX-rP） in their ability to differentiate benign and malignant breast lesions. Methods Eighty-three females with 101 lesions in the breast were prospectively studied. Pathologic outcome was used as the golden diagnosis criterion. The sensitivity, specificity, accuracy, Youden index, positive and negative predictive values of UE for diagnosing breast diseases were compared. Receiver operating characteristic （ ROC ） curve was used to assess the diagnostic value of UE. Results Sensitivity of UE was 87.06% , speeificities, accuracy, and Youden index were 93.05% , 91.08%, and 83.30%, respectively. The positive and negative predictive values were 94.36% and 80. 10%. Those of MX-rP were 72.40%, 83.33%, 80. 19%, 87.74%, 89.55%, and 63.52%, respectively. The positive and negative-likelihood ratio for UE was 12.41（95% CI,5.90 to 26. 88） and 0. 14（95% CI, 0.06 to 0.30） ; and those for MX-rP, the values were 4.34（95%CI, 1.63 to 11.42） and0.33（95%CI, 0.19 to0.63）, respectively. Area under ROC in uhrasonic elastography was 0. 954 （95 % CI, 0. 912 to 0. 996 ）. Conclusion UE has better diagnostic value than MX-rP in breast masses.