自动乳腺容积成像及实时组织弹性成像在鉴别乳腺病灶中的价值

Clinical value of automatic breast volume scanner and real-time tissue elastography in differential diagnosis of breast lesions

目的探讨自动乳腺全容积扫查系统及实时组织弹性成像在乳腺良恶性病灶鉴别诊断中的临床应用价值。方法回顾性分析86例(98个病灶)经病理证实的乳腺病灶,比较自动乳腺全容积扫查系统与实时组织弹性成像分别使用及两者联合诊断结果的差异。结果 98个病灶中,病理结果显示良性病灶50个、恶性病灶48个。自动乳腺全容积扫描系统对恶性病灶诊断的灵敏度为83.3%、特异度为82.0%、准确率为82.6%;实时组织弹性成像对恶性病灶诊断的灵敏度为81.2%、特异度为80.0%、准确率为80.6%;两者联合灵敏度为91.7%、特异度为86.0%、准确率为88.8%。联合诊断的灵敏度、特异度、准确率均高于ABVS、RTE单独检查(χ2=4.17,P=0.031;χ2=6.13,P=0.008,差异有统计学意义),而单独使用ABVS和RTE差异无统计学意义(χ2=0.30,P=0.500)。结论自动乳腺全容积扫查系统与实时组织弹性成像对乳腺良恶性病灶的鉴别诊断均具有较高的价值,两种检查方式结合有利于对乳腺病灶鉴别诊断水平进一步提高。

Objective To investigate the clinical value of automatic breast volume scanner（ABVS） combined with Realtime Tissue Elastography（RTE） in differential diagnosis of breast lesions. Methods ABVS and RTE were applied to 86 patients with 98 breast lesions,which were confirmed by biopsy or surgical pathology. The result of use ABVS, RTE separately and the combined use of two examinations were analyzed retrospectively. Results Pathological results showed that there were 50 benign lesions and 48 malignant lesions in the 98 breast lesions. The sensitivity, specificity and accuracy of ABVS were 83.3% ,82.0% and 82.6%, respectively ;which of RTE were 81.2% ,80.0% and 80.6%, respectively;and which of combined use of two examinations were 91.7%, 86.0% and 88.8% , respectively. The sensitivity, specificity, accuracy of combination of two examinations for differential diagnosing breast lesions were significantly higher than those of ABVS and RTE separately（ X^2= 4. 17, P = 0. 031 ;X^2 = 6. 13, P = 0. 008, respectively ）, and there was no significant difference between ABVS and RTE（ X^2 = 0.30 ,P = 0. 500 ）. Conclusion ABVS and RTE had certain advantage in the differential diagnosis of breast 1 esions. And the combination of two examinations can further help to differentiate the breast lesions.