超声弹性成像评分法联合面积比值法在乳腺良恶性病变诊断中的应用

Application of ultrasound elastography 5-point scores and ratio of traced area in diagnosis of breast diseases

目的探讨超声弹性成像(UE)技术中评分法联合面积比值法对乳腺良恶性病变的诊断价值。方法对134例(178个肿块)乳腺病变患者进行UE检查,先用5分评分法给肿块评分,然后测量面积比(肿块弹性图像面积/肿块二维图像面积),以病理结果作为金标准,构建受试者操作特性(ROC)曲线,判断乳腺良恶性病变诊断的最佳界值。结果 UE评分≥4分诊断乳腺良恶性病变的敏感度、特异度和准确性分别为78.8%,93.8%和91.0%。面积比值法诊断乳腺良恶性病变的敏感度、特异度和准确性分别为75.8%,95.8%,92.1%。二者对乳腺良恶性病变的诊断差异无统计学意义(Ρ>0.05)。乳腺良恶性病变诊断的最佳界值是1.45。二者联合诊断的敏感度、特异度和准确性分别为90.9%,98.6%,97.2%。联合诊断与5分评分法、面积比值法的准确性两两比较,差异有统计学意义(Ρ<0.05)。结论 UE面积比值法与5分评分法对乳腺良恶性病变的诊断价值相当,二者联合可提高诊断的准确性。

Objective To evaluate the application of ultrasound elastography （UE） 5-point scores and ratio of traced area in diagnosis of breast diseases. Methods One hundred and thirty foure patients with 178 lesions were examined with UE. And 5-point scores were applied at first, and then the area ratios were calculated. The receiver operating characteristic （ROC） curve was established to evaluate diagnostic value. The histology results were used as the golden standard. The optimal cut-off point was calculated. Results The sensitivity, speciifcity and accuracy of 5-point scores （score≥4） were 78.8%, 93.8%and 91.0%respectively. The sensitivity, speciifcity and accuracy of ratio of traced area were 75.8%, 95.8%, 92.1%respectively. There was no signiifcant difference between these two diagnostic methods （Ρ〉0.05）. The cut-off of ratio of traced area was 1.45. When combining these two methods, the sensitivity, speciifcity and accuracy were 90.9%, 98.6%, 97.2%respectively. The accuracy was signiifcantly improved （Ρ〈0.05）. Conclusions The ratio of traced area and 5-point scores were both valuable diagnostic approaches. The combination of the two methods can improve the accuracy of diagnosis.