超声弹性成像在乳腺微小实质性病变定性诊断中的应用价值

Applications of ultrasound elastography in diagnosis of breast tiny substantive lesions

目的 探讨超声弹性成像（UE）在乳腺微小实质性病变（病灶最大直径≤10 mm）定性诊断中的应用价值.方法 回顾性分析临床病理明确诊断的82例乳腺微小实质性病变患者的UE检查资料,并将UE与病理诊断结果进行比较.结果 乳腺微小实质性病变UE随病变性质不同而表现不同的弹性评分,UE总检出率为93.7％（89/95）.4分病灶误诊1个,病理诊断为乳腺纤维瘤并钙化;3分病灶误诊5个,病理诊断分别为浸润性导管癌1个、导管内原位癌2个、浸润性小叶癌2个.乳腺微小癌的检出率为80.0％（20/25）.UE与病理诊断结果比较差异无统计学意义（P＞0.05）.病灶整体应变率在乳腺微小良恶性病灶比较差异有统计学意义（P＜0.05）.结论 UE及实时应变技术在乳腺微小实质性病变定性诊断中价值较大,对临床较难诊断的病灶有一定的补充诊断作用.

Objective To analyze the clinical value of ultrasound elastography （UE） in qualitative diagnosis of breast tiny （≤ 10 mm） substantive lesions.Methods The clinical UE examination data of recent clinical pathology diagnosis of 82 cases of breast tiny lesions were analyzed retrospectively,and compared with pathology results for statistical analysis.Results With the lesions nature was different,the UE elasticity score of breast parenchymal lesions wasdifferent,the UE overall detection rate of breast small lesions was 93.7% （89/95）.Four points 1 lesion misdiagnosed,pathologic diagnosis of mammary gland fibroma and calcification.Three points 5 lesions misdiagnosed,pathological diagnosis were 1 of invasive ductal carcinoma,2 of intraductal carcinoma in situ,2 of invasive lobular carcinoma.The detection rate of tiny breast cancer was 80.0% （20/25）.There was no significant difference between UE and the pathological diagnosis （P〉 0.05）.Elastic strain rate in the tiny benign and malignant breast lesions had significant difference （P 〈 0.05）.Conclusion UE and real-time strain techniques have larger clinical diagnosis value in breast tiny substantive lesions,and a certain complementary role for the lesions which are difficult to diagnose.