多种超声技术与X线钼靶联合诊断乳腺癌的应用价值

Value of different ultrasonic techniques combined with mammography in diagnosis of breast cancer

目的探讨多种超声技术与X线钼靶联合诊断乳腺癌的价值。方法回顾性分析经我院常规超声初拟诊为乳腺癌的94例患者的影像学资料,分析常规超声、X线钼靶、超声弹性成像(UE)及超声造影4种技术单一和不同联合应用对乳腺癌诊断价值的差异。结果常规超声+X线钼靶+UE联合应用诊断乳腺癌的敏感性、特异性、准确性、阳性预测值、阴性预测值及ROC曲线下面积分别为93%、97%、93%、30.27、0.07及0.9590;其ROC曲线下面积诊断效能与常规超声+X线钼靶+超声造影联合应用相同。乳腺浸润性导管癌常规超声和超声造影的检出率分别为96.5%和98.2%,浸润性小叶癌常规超声和超声造影的检出率分别为77.8%和88.9%,导管内原位癌X线钼靶检出率为85.7%。常规超声和超声造影对乳腺浸润性导管癌及浸润性小叶癌的检出率较X线钼靶高;X线钼靶对乳腺导管内原位癌的检出率较常规超声和超声造影高。结论常规超声、UE、X线钼靶及超声造影对不同病理类型的乳腺癌检出率有差异,但常规超声+X线钼靶+UE/超声造影联合应用可全面获得病灶信息,为乳腺癌诊断及鉴别诊断提供可靠依据,且常规超声+X线钼靶+UE联合应用更经济、方便,值得推广。

Objective To evaluate the diagnostic value for breast cancer using the combined multiple ultrasonic techniques and mammography. Methods Ninety-four patients with doubted breast cancer diagnosed using two-dimensional ultrasound were enrolled in this study. The techniques of mammography,elastography and contrast-enhanced ultrasound were used solely or combined together to detect all of the lesions. The diagnostic value for breast cancer was analyzed and compared between using different combination of techniques. Results According to this study,the four techniques have different diagnostic value for breast cancer in different stage. Using elastography and contrast-enhanced ultrasound, the diagnostic rate for the breast infiltrating ductal carcinoma were 96.5% and 98.2% ,for the infiltrating lobular carcinoma were 77.8% and 88.9%. The diagnostic rate of mammography on ductal carcinoma in situ was 85.7%. The sensitivity,specificity,accuracy,positive predictive value,negative predictive value and AUC for breast cancer using combined conventional ultrasound,mammography and ultrasonic elastography were 93% ,97% ,93% ,30.27,0.07 and 0.9590,respectively. Conclusion The diagnosis value for breast cancer diagnosis using conventional ultrasound, mammography,elastography is different. Doctors can get more comprehensive information of the lesions for breast cancer diagnosis using combined techniques.