乳腺超声自动容积成像技术与普通超声对乳腺肿物的诊断价值比较

Comparative study of automatic breast volume scanner and hand-hold ultrasound in the diagnosis of breast lesions

目的对比乳腺超声自动容积成像（automated breast volume scanner，ABVs）技术与普通超声诊断乳腺肿物的结果，评价ABVS对乳腺肿物的诊断价值。方法利用普通超声及ABVS对140例女性患者共172个乳腺肿物进行检查，以病理结果为金标准，对比分析普通超声、ABVS以及两者结合诊断乳腺肿物的诊断效能。结果普通超声诊断乳腺肿物的敏感性为89．0％，特异性为75．0％，准确性为83．1％，阳性预测值为83．2％，阴性预测值为83．1％；ABVS诊断乳腺肿物的敏感性为97．0％，特异性为80．6％，准确性为90．1％，阳性预测值为87．4％，阴性预测值为95．1％；两者结合诊断乳腺肿物的敏感性为99．0％，特异性为88．9％，准确性为94．8％，阳性预测值为92．5％，阴性预测值为98．5％。ABVS诊断乳腺肿物的敏感性和准确性高于普通超声，差异均具有统计学意义（χ2=4．080、4．320，P〈0．05）。ABVS与普通超声两者结合诊断乳腺肿物的特异性、准确性高于ABVS，差异均具有统计学意义（χ2=4．200、6．130，P〈0．05），两者联合诊断乳腺肿物的敏感性、特异性、准确性高于普通超声，差异均具有统计学意义（χ2=8．100、8．100、18．050，P〈O．05）。ABVS对乳腺病灶检出率（99．4％）高于普通超声（93．0%），差异具有统计学意义（χ2=7．690，P〈0．05）。普通超声、ABVS对肿物微钙化检出率分别为90．3％（56／62）、95．2％（59／62），两者差异无统计学意义（χ2=0．800，P〉0．05）。“汇聚征”诊断乳腺癌的敏感性为58．0％，特异性为100％，准确性为75．6％。结论ABVS特有的冠状面图像能为乳腺病灶的诊断提供更多信息，ABVS与普通超声联合能提高诊断的准确性，具有良好的临床应用前景。

Objective To compare the result of automated breast volume scanner（ABVS）and common ultrasound in diagnosis of breast lesions, and evaluate the value of ABVS in diagnosing breast lesions. Methods One hundred and forty women patients with 172 breast lesions were identified by common ultrasound and ABVS, and their diagnosis efficiency were contrasted and analyzed according to the gold standard of pathology. Results The sensitivity, specificity, accuracy, positive predictive and negative predictive rate of common ultrasound were 89.0%, 75.0%, 83.1%, 83.2%, 83.1%, respectively; those of ABVS were 97.0 %, 80.6 %, 90.1%, 87.4 %, 95.1%, respectively ; those of combined two examinations were 99.0%,88.9%,94.8%,92.5%,98.5%. The sensitivity and accuracy rate of ABVS for diagnosing breast lesions were significantly higher than those of common ultrasound （χ2 = 4.080, 5.330, P 〈0.05）. The specificity and accuracy rate of the combination of two examinations were significantly higher than those of ABVS （χ2 = 4.200,6. 130, P 〈0.05）. The sensitivity, specificity and accuracy rate of the combination of two examinations were significantly higher than those of common ultrasound （χ2 = 8. 100, 8. 100, 18. 050, P 〈 0.05）. The detection rate of common ultrasound and ABVS were 93.0% and 99.4% （χ2 = 7.690,P 〈 0.05）. The microcalcifications detection rate of common ultrasound and ABVS were 90.3 % （59/62） and 95.2% （59/62） （χ2 = 0.800, P 〈0.05）. The sensitivity, specificity and accuracy rate of retraction phenomenon in coronal plane were 58.0%, 100% and 75.6%. Conclusions The specific coronal plane of ABVS can provide additional information in the diagnosis of breast lesions. Combination of ABVS and common ultrasound can improve the diagnostic accuracy. ABVS plays an important role in diagnosis of breast disease.