超声对致密型乳腺疾病的诊断价值

Clinical value of ultrasonography in dense breasts by mammography

目的探讨超声在致密型乳腺疾病中的诊断价值。方法回顾性分析115例致密型乳腺患者和304例非致密型乳腺患者的超声声像图表现,并与其钼靶X线检查结果和病理结果相比较,统计分析超声对致密型乳腺疾病的检出率和诊断准确率。结果超声对致密型、非致密型乳腺中的病灶检出率分别为96.3%、98.3%,均显著高于钼靶(36.0%、83.7%;P<0.01)。在致密型乳腺患者中,超声对乳腺癌的诊断敏感度显著高于钼靶(83.9%、51.6%;P<0.01),但超声对乳腺癌的诊断特异度低于钼靶(88.6%、98.1%;P<0.01),两者对于乳腺癌的诊断准确度均为87.5%。超声和钼靶对于非致密型乳腺的乳腺癌诊断敏感度、特异度、准确度差异均无统计学意义(P>0.05)。结论乳腺超声显著提高了致密型腺体中病灶的检出率和乳腺癌的诊断敏感度,是致密型乳腺患者重要补充检查手段。

Objective To evaluate the role of breast ultrasonography in women with dense breast tissue by mammography. Methods The breast uhrasonography appearance in 115 patients with dense breasts and 304 patients without dense breasts were. retrospectively analyzed. The findings by ultrasound, mammography and subsequent histopathology were used to calculate the detection rate, sensitivity, specificity and accuracy of breast ultrasonography. Results The detection rates of breast neoplasms by uhrasonography in patients with or without dense breast were 96.3% and 98.3%, respectively, which were significantly higher than mammography （36.0% , 83.7% , P 〈0.01 ）. In the dense breasts, the diagnostic sensitivity for breast cancer by uhrasonography was higher than that by mammograpby （ 83.9%, 51. 6%, P 〈 0.01 ）, while the diagnostic sensitivity of uhrasonography was lower than that by mammography （ 88.6%, 98.1%, P 〈0.01 ）. The diagnostic accuracy rate of the two methods was 87.5%. In the patients without dense breast, no statistical difference was found in the diagnosis for sensitivity, specificity and accuracy of the two imaging techniques （ P 〉 0.05 ）. Conclusion The breast uhrasonography could significantly improve the detection rate of breast neoplasm and the diagnosis sensitivity of breast cancer in the dense breasts by mam- mography, which could be a useful supplement for screening mammography in women with dense breast.