超声弹性成像定性诊断乳腺癌

Ultrasonic elastography in qualitative diagnosis of breast cancer

目的探讨超声弹性成像定性诊断乳腺癌的价值。方法对230例女性患者(243个肿块)于手术或病理活检前行常规二维超声及多普勒超声检查,并按照乳腺影像数据报告系统(BI-RADS)标准进行诊断分类;之后对病变行超声弹性成像,采用5分法对其评分。以病理结果为金标准,比较两种方法诊断乳腺癌的准确率。结果超声弹性成像诊断乳腺恶性病变的敏感度、特异度、准确率分别为93.85%(122/130)、94.69%(107/113)、94.24%(229/243)。常规超声诊断乳腺恶性病变的敏感度、特异度、准确率分别为92.31%(120/130)、86.72%(98/113)、89.71%(218/243)。两种方法诊断恶性肿瘤的准确率差异有统计学意义(χ2=4.17,P<0.05)。结论超声弹性成像诊断乳腺癌的准确性优于常规二维超声及多普勒超声,具有重要诊断及鉴别诊断价值。

Objective To observe the value of ultrasonic elastography in qualitative diagnosis of breast cancer. Methods Totally 243 breast lesions in 230 female patients before surgical operation or pathological biopsy were examined with twodimensional gray scale ultrasound and color Doppler flowing imaging （CDFI）, and then graded according to breast imaging- reporting and data system standard. Then ultrasonic elastography was performed, and the tumors were graded using 5-score evaluating method. Taking pathological findings as gold standards, the accuracy of ultrasonic elastography and conventional ultrasound were compared. Results The sensitivity, specificity, accuracy of ultrasonic elastography was 93.85% （122/130）, 94.69% （107/113）, 94.24% （229/243）, of conventional ultrasound was 92.31% （120/130）, 86. 72% （98/ 113）, 89.71%（218/243）, respectively. The accuracy of ultrasonic elastography was higher than that of conventional ultrasound （X^2=4. 17, P〈0.05）. Conclusion The accuracy of ultrasonic elastography is higher than that of conventional ultrasound. Ultrasonic elastography has important value in diagnosis and differential diagnosis of breast cancer.