三种超声弹性定量参数对乳腺疾病鉴别诊断的探讨

Investigation of three kinds of quantitative ultrasound elastic parameters in the differential diagnosis of breast disease

目的探讨三种超声弹性成像定量参数在乳腺良恶性病变中的应用价值。方法对68例乳腺肿块患者、92个病灶进行弹性成像三种定量参数检查,以病理结果作为金标准,良性组40例55个病灶,恶性组28例37个病灶,三种定量参数(面积比、直径比、直径变化率)比较绘制ROC曲线,得出鉴别诊断乳腺肿块良恶性准确性最高的定量参数,并确定该定量参数法灵敏度、特异度最佳时的诊断临界值,为鉴别乳腺肿块的良恶性提供更客观的依据。结果肿块的面积比、直径比及直径变化率及定量参数在良恶性组间差异均有统计学意义(P<0.05);比较三种定量参数比值的ROC曲线下面积,直径比>直径变化率>面积比,因此直径比在鉴别乳腺肿块良恶性的准确性更高,并确定1.15为直径比值法在灵敏度、特异度最佳时的诊断临界值。结论超声弹性成像定量分析有助于乳腺病灶良恶性的鉴别,其中直径比值法诊断准确性优于直径变化率、面积比值法,为乳腺超声弹性成像提供了新的诊断方法。

Objective To evaluate three kinds of quantitative ultrasound elastic parameters in the differential diagnosis of breast disease.Methods 68 patients with breast lumps,a total of 92 lesions,received three kinds of quantitative parameters elasticity imaging inspects.The tumor was divided into two parts according to pathology results： in benign group,40 patients with 55 lesions;in malignant group,28 patients with 37 lesions.3 kinds of quantitative parameters were compared,and ROC curve was established for finding a highest accuracy parameter in identifying breast tumors,confirming the specificity,sensitivity optimal diagnostic threshold.The purpose was to provide a more objective basis with identify benign and malignant breast tumors.Results The ratios of tumor in diameter ratio and area ratio and the rate change in diameter in UE images and B-mode images were statistically different between benign and malignant lesions（P0.05）.According to ROC analysis,diameter ratio was higher than the rate change in diameter,and the area ratio was the lowest among them.Therefore diagnostic accuracy of the ratio of diameter was superior to the other two.It was the threshold of specificity,sensitivity optimal diagnostic when the diameter ratio at 1.15.Conclusion Elasticity imaging can reflect relative stiffness of breast lesions objectively.The diagnostic accuracy of the ratio of diameter is superior to the rate of changes in diameter and area ratio.