常规超声联合自动乳腺全容积成像诊断乳腺良恶性病变

Clinical value of conventional handheld ultrasonography combined with automated breast volume scanning in the diagnosis of benign and malignant breast lesions

目的研究常规超声(HHUS)联合自动乳腺全容积成像(ABVS)诊断乳腺良恶性病变的临床价值。方法 2011年12月至2014年12月华东疗养院进行健康体检的人群经HHUS筛查出123患者共156个乳腺占位性病灶,对该类患者再进行ABVS检查,并以病理类型诊断为金标准,采用ROC分析方法计算敏感度、特异性、阳性预测值、阴性预测值、准确率。结果①病理类型诊断显示156个占位性病变中恶性病变51个,良性病变105个;②单用HHUS诊断恶性病变的敏感度74.51%、特异性79.05%、阳性预测值63.33%、阴性预测值86.46%、准确率77.56%;单用ABVS诊断恶性病变的敏感度84.31%、特异性86.67%、阳性预测值75.44%、阴性预测值91.92%、准确率85.90%;HHU S联合ABVS诊断时,当至少一个提示恶性病变时诊断的敏感度96.08%、特异性75.23%、阳性预测值65.33%、阴性预测值97.53%、准确率82.69%。结论 HHUS联合ABVS诊断有助于早期发现乳腺恶性病变,健康体检机构在筛查中应予以重视。

Objective To study the clinical value of conventional handheld ultrasonography （HHUS） combined with automated breast volume scanning （ABVS） in the diagnosis of benign and malignant breast lesions. Methods Totally 156 breast lesions were screened in 123 women undergoing health examination in East China Nursing Home from December 2011 to December 2014. Those patients underwent ABVS, and finally clear diagnosis of pathological type was taken as gold standard. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy rate were calculated by ROC analysis. Results Among 156 breast lesions, pathology revealed 51 malignant lesions and 105 benign ones. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy rate were 74.51%o, 79.05%, 63.33% ,86.46% and 77.56%, respectively with single HHUS in diagnosis of malignant lesions, and those were 84.31%, 86.67%, 75.44%, 91.92% and 85.90%, respectively with single ABVS in diagnosis of malignant lesions. When combining HHUS with ABVS, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy rate were 96.08% , 75.23% , 65.33%, 97.53% and 82.69% , respectively. Conclusion HHUS combined with ABVS is helpful for early diagnosis of malignant breast lesions, and health examination institutions should pay more attention to its use in screening malignant disease.