超声造影5分法诊断乳腺肿物的价值初探

Initial study of contrast-enhanced ultrasound 5-point scoring system in the diagnosis of breast tumor

目的探讨超声造影5分法在乳腺良恶性肿物鉴别诊断中的应用价值。方法对进行乳腺肿物切除的患者249例共260病灶，术前均进行乳腺弹性成像及超声造影检查，运用弹性成像新5分评分及超声造影5分法分别对病灶进行评分，以病理结果为金标准，对两种方法的诊断效能进行比较。结果260个肿物中，良性病灶145个，恶性病灶115个。弹性成像诊断的准确性、特异性、敏感性分别为85．0％，88．3％，80．1％。超声造影诊断的临界值为3～4分，其诊断准确性、特异性、敏感性分别为88．9％，87．6％，90．4％。两种方法诊断水平的ROC曲线下面积分别为弹性成像0．901，超声造影0．910，两者之间的差异无统计学意义（Z=0．345，P=0．730）。结论超声造影5分法初步提供了对乳腺肿物鉴别诊断的量化指标，诊断效能较高，但仍需大样本研究进一步完善该评分法。

Objective To explore the application of contrast-enhanced scoring system in the diagnosis of breast tumor. Methods 249 patients with 260 lesions were examined by elastography and contrastenhanced ultrasound before surgery. All the lesions were scored according to the two different methods. Pathological results were made the golden criteria. The diagnosis accuracy of the two methods were compared. Results There were 145 benign and 115 malignant tumors. The diagnosis accuracy, specificity and sensibility of elastography were 85.0%,88.3%, 80.1% respectively. The critical value of contrastenhanced ultrasound was between 3 and 4. The diagnosis accuracy, specificity and sensibility of contrastenhanced ultrasound were 88.9% ,87.6% ,90.4% respectively. Area under ROC curve of the two methods were 0. 901 and 0. 910, the difference was not statistically significant. Conclusions Contrast-enhanced ultrasound 5-point scoring system was an initial quantitative criterion for breast tumor diagnosis. The diagnosis accuracy was parallel to that of elastography.