比较超声弹性成像与CDFI鉴别诊断良恶性乳腺病变

Comparison of ultrasound elastography and color Doppler ultrasound in differential diagnosis of breast neoplasms

目的比较超声弹性成像与CDFI在鉴别诊断良恶性乳腺病变中的应用价值。方法随机选取155例乳腺病变术前患者行超声弹性成像及CDFI检查。CDFI依据Alder血流分级法、弹性成像采用5分法进行评估。以病理结果为金标准,比较两种技术诊断乳腺病变的敏感度、特异度及准确率。结果 155例共检出187个乳腺病灶,其中恶性57个、良性130个。CDFI与弹性评分诊断乳腺病变的敏感度、特异度及准确率分别为68.42%(39/57)、75.38%(98/130)、73.26%(137/187)及84.21%(48/57)、84.62%(110/130)、84.49%(158/187);弹性成像的敏感度及准确率均高于CDFI(P均<0.05),而二者特异度的差异无统计学意义(P>0.05)。CDFI和弹性成像诊断乳腺病变的ROC曲线下面积分别为0.789及0.892。结论超声弹性成像鉴别诊断乳腺良恶性病变的效能高于CDFI。

Objective To compare the value of ultrasound elastography （UE） and CDFI in differential diagnosis of benign and malignant breast neoplasms. Methods Totally 155 patients with breast tumor were randomly chosen and underwent CDFI and UE. CDFI assessment was based on Alder flow classification, whereas elastographic assessment was based on 5-point scoring method. Taking histological diagnosis as golden standards, the sensitivity, specificity, and accuracy in diagnosis of breast tumors of each technique were compared. Results Totally 187 breast lesions were detected in 155 patients, 57 were malignant and 130 were benign. The sensitivity, specificity and accuracy of CDFI and UE was 68.42% （39/57）, 75.38% （98/130）, 73.26% （137/187） and 84.21% （48/57）, 84.62% （110/130）, 84.49% （158/187）, respectively. The sensitivity and accuracy of elastography were significantly better than CDFI （both P〈0.05）, whereas there was no statistical difference of the specificity between CDFI and UE （P〉0.05）. The areas under the ROC curves of CDFI and UE was 0.789 and 0.892, respectively. Conclusion The diagnostic performance of UE is better than CDFI in differential diagnosis of benign and malignant breast tumors.