超声直接和间接征象特征赋值评分对乳腺肿块的诊断价值

Diagnostic value of score assignment for ultrasound characteristics of direct and indirect signs on breast neoplasm

目的：探讨超声直接和间接征象特征赋值评分对乳腺实性肿块良恶性的诊断价值。方法采用彩色多普勒超声诊断技术对97例乳腺实性肿块患者104枚肿块进行超声直接和间接征象评分，并与术后病理结果进行对照，比较良恶性肿块直接和间接征象评分差异。结果恶性乳腺实性肿块超声直接和间接征象检出率均显著高于良性肿块（χ2值分别为9．898、11．656，均P＜0．05），对乳腺肿块直接征象和间接征象进行积分后显示，恶性肿块直接征象和间接征象积分均显著高于良性肿块（t直接征象值为10．308～41．835、t间接征象值为11．652～34．938，均P＜0．05）。直接征象最佳临界值为4分，诊断灵敏度、特异度和准确度分别为0．83、0．94和89．40％；间接征象最佳临界值为1分，诊断灵敏度、特异度和准确度分别为0．81、0．75和76．90％；两者联合最佳临界值为5分，诊断灵敏度、特异度和准确度分别为0．89、0．92和93．30％。结论超声直接、间接征象积分有助于诊断肿块的良恶性，具有一定临床价值。

Objective To explore the diagnostic value of score assignment for ultrasound characteristics of direct and indirect signs on benign or malignant breast neoplasm.Methods Color Doppler ultrasound was performed to assign direct and indirect signs scores for 97 cases of solid breast masses with 104 neoplasms, and the results were compared with pathological findings to analyze the difference in direct and indirect signs score between benign or malignant breast neoplasm.Results Ultrasound direct and indirect signs detection rates of malignant solid breast were significantly higher than those of benign tumor （χ2 value was 9.898 and 11.656, respectively, both P〈0.05） . Direct signs and indirect signs scores of malignant neoplasms were significantly higher than those of benign ones （ tdirect signs ranged 10.308-41.835, tindirect signs ranged 11.652 -34.938, respectively, both P 〈0.05）.The optimal cut-off value of direct sign was 4, and the diagnostic sensitivity, specificity and accuracy was 0.83, 0.94 and 89.40%, respectively.The optimal cut-off value of indirect sign was 1, and the diagnostic sensitivity, specificity and accuracy was 0.81, 0.75 and 76.90%, respectively.Combined optimal cut-off value was 5, and the diagnostic sensitivity, specificity and accuracy was 0.89, 0.92 and 93.30%, respectively.Conclusion Ultrasonic direct and indirect signs integral are helpful to the diagnosis of benign and malignant tumors with certain clinical value.