声弹性成像及造影技术与超声引导穿刺活检对乳腺病灶鉴别诊断价值的对比研究

A Comparative Study on the Diagnostic Value of Acoustic Elastography and Ultrasonography and Ultrasound- guided Biopsy in the Differential Diagnosis of Breast Lesions

目的:比较声弹性成像检查、超声造影检查与超声引导经皮穿刺活检对乳腺病灶良恶性的鉴别诊断价值。方法:对经手术病理证实的29例30个乳腺病灶术前进行常规超声检查、声弹性成像检查、超声造影检查以及超声引导穿刺活检,依据声弹性成像5分法和超声造影相关指标,分别对病灶做良恶性诊断。结果:在30例乳腺病灶中,恶性18例、良性12例;声弹性成像诊断乳腺良恶性病灶的敏感度88.9%(16/18)、特异度83.3%(10/12)、准确率86.7%(26/30)、阳性预测值88.9%(16/18)、阴性预测值83.3%(10/12),超声造影诊断乳腺良恶性病灶的敏感度77.8%(14/18)、特异度83.3%(10/12)、准确率80.0%(24/30)、阳性预测值87.5%(14/16)、阴性预测值71.4%(10/14),超声引导穿刺活检诊断乳腺良恶性病灶的敏感度94.4%(17/18)、特异度100.0%(12/12)、准确率96.7%(29/30)、阳性预测值100.0%(17/17)、阴性预测值92.3%(12/13)。结论:超声引导穿刺活检对乳腺病灶定性诊断具有绝对优势,超声造影较弹性成像敏感度、特异度、准确率、阳性预测值、阴性预测值稍低于超声引导穿刺活检。

ObjectiVe：To compare the diagnostic Value of acoustic elastography,ultrasonography and ultrasound-guided biopsy in the differential diagnosis of malignant and benign breast lesions. Methods：PreoperatiVe ultrasound,acoustic elastogra-phy,ultrasonography and ultrasound-guided biopsy were performed in 30 breast lesions of 29 cases of breast disease,with the breast lesions diagnosed for malignance and benignancy by 5-category diVision and related contrast-enhanced ultrasound inde-Xes. ResuIts：Of 30 breast lesions,there were 18 malignant ones and 12 benign ones. With acoustic elastography diagnosis of benign and malignant lesions,the sensitiVity is 88. 9 %（16/18）,the specificity 83. 3 %（10/12）,the accuracy rate 86. 7 %（26/30）,positiVe predictiVe Value 88. 9%（16/18）and negatiVe predictiVe Value is 83. 3%（10/12）. With Ultrasonography, the sensitiVity is 77. 8 %（14/18）,the specificity 83. 3 %（10/12）,the accuracy rate 80. 0 %（24/30）,the positiVe predic-tiVe Value 87. 5 %（14/16）,and negatiVe predictiVe Value is 71. 4 %（10/14）. With ultrasound-guided biopsy diagnosis of benign and malignant breast lesions,the sensitiVity is 94. 4% in the（17/18）,the specificity 100. 0%（12/12）,the accuracy rate 96. 7 %（29/30）,the positiVe predictiVe Value 100. 0 %（17/17）and the negatiVe predictiVe Value is 92. 3 %（12/13）. ConcIusion：Ultrasound-guided needle biopsy enjoys the absolute superiority oVer acoustic elastography and ultrasonography in differential diagnosis of breast lesions,whose sensitiVity,specificity,accuracy rate ,positiVe predictiVe Value and negatiVe pre-dictiVe Value were lower.