常规超声结合弹性成像对乳腺肿块良恶性的鉴别诊断价值

Value of conventional ultrasound combined with the elastic imaging in differential diagnosis of benign and malignant breast masses

目的：探讨常规超声结合弹性成像对乳腺肿块良恶性的鉴别诊断价值。方法98例乳腺肿块患者共106个肿块，其中良性60个，恶性46个；术前行常规超声和弹性成像检查，并与术后病理结果对照。结果乳腺良性肿块弹性评分1～3分53例，占88．33％，平均（1．95±1．06）分；恶性肿块弹性评分4～5分35例，占76．09％，平均（4．02±0．95）分，两者差异有统计学意义（P＜0．05）。以弹性评分≥4分为界点，常规超声联合弹性成像诊断乳腺恶性肿块的敏感性、特异性、准确性分别为93．48％、88．33％、90．57％；联合应用诊断乳腺肿块良恶性的敏感性、准确性高于单独应用常规超声和弹性评分法（均P＜0．05），三者诊断特异性差异无统计学意义。结论乳腺良恶性肿块弹性评分分布情况各有特点，超声弹性成像联合常规超声能提高对乳腺肿块良恶性的鉴别诊断能力。

Objective To explore the value of conventional ultrasound combined with the elastic imaging in the differential diagnosis of benign and malignant breast masses. Methods A total of 98 patients with 106 breast masses,including 60 benign and 46 malignant nodules were underwent conventional ultrasound and elasticity imaging,and compared with the postoperative pathological results. Results There were 53 cases with elasticity score from 1 to 3 points in benign group, accounting for 88.33%,and the average score was 1.95 ±1.06. There were 35 cases with elasticity score from 4 to 5 points in malignant group,accounting for 76.09%,and the average score was 4.02 ±0.95. There was significant difference between the two groups （P〈0.05）. In combination with the elastic score≥4,the sensitivity,specificity,accuracy of combinational ultrasound for the diagnosis of malignant breast masses were 93.48%,88.33%,90.57%,the sensitivity and accuracy were higher than conventional ultrasound or elastic scoring diagnosis alone （P＆lt;0.05）. No significant difference in the diagnostic specificity was found among the three groups. Conclusion Elastic score distribution of benign and malignant breast masses have different features,ultrasound elasticity imaging based on tissue hardness,combined with conventional ultrasound can improve the ability of differential diagnosis.