常规超声结合弹性成像对乳腺导管内乳头状病变的诊断价值

Diagnostic value of conventional ultrasonography combined with ultrasonic elastography for breast intraductal papillary lesion

目的乳腺导管内乳头状病变的发病低,但恶变率高。常规超声(ultrasonography,US)对其诊断准确率不高。文章探讨US结合弹性成像(ultrasonic elastography,UE)对乳腺导管内乳头状病变的诊断价值。方法分析48例患者63个乳腺导管内乳头状病变患者的术前超声检查资料,根据二维超声图像(two-dimensional ultrasonography,2DUS)特征进行分型,并结合彩色多普勒血流现象及UE特征进行超声综合评级后与病理结果对照。结果乳腺导管内乳头状病变根据2DUS图像分为4种类型。常规US结合UE诊断乳腺导管内乳头状病变的灵敏度、特异度及准确率分别为93.3%、88.9%和90.5%,而常规US分别为75.6%、66.7%和73.0%;2种方法诊断导管内乳头状病变的ROC曲线下面积,差异有统计学意义(0.918 vs 0.838,P<0.05)。结论常规US结合UE可提高对乳腺导管内乳头状病变的诊断价值。

Objective Breast intraductal papillary lesion （ BIPL） has a low incidence but a high rate of malignancy .This study discusses the diagnostic value of conventional ultrasonography （ US） combined with ultrasonic elastography （ UE） for breast papil-lary lesion. Methods We analyzed the preoperative ultrasound data of 48 patients with 63 BIPLs, and classified them according to the characteristics of two-dimensional ultrasound （2DUS） images.Then we compared their color Doppler ultrasound characteristics and UE features with the pathological results . Results Based on the 2DUS findings, the BIPLs were divided into 4 types.The sensitivi-ty, specificity, and accuracy of conventional US ＋UE in the diagnosis of BIPL were 93.2%, 88.9%, and 90.5%, respectively, markedly higher than those of conventional US （75.6%, 66.7%, and 73.0%）, with statistically significant differences in the areas under the curve between the two methods （0.918 vs 0.838, P〈0.05）. Conclusion Conventional US combined with UE can im-prove the diagnosis of breast intraductal papillary lesion .