二维超声和多普勒超声在乳腺肿块中的鉴别诊断价值

differential diagnosis value of two-dimensional ultrasound and Doppler ultrasound in breast mass

目的探讨二维超声和多普勒超声在乳腺肿块鉴别诊断中的价值。方法选取2013年1月～2015年12月我院收治的400例乳腺肿块患者为研究对象，按照不同的检查方法分为二维超声组和多普勒超声组．分别采用二维超声和多普勒超声检查诊断。以病理诊断为“金标准”，判定二维超声和多普勒超声在恶性乳腺肿块诊断中敏感度和特异度，比较两组患者诊断阳性率、误诊率、漏诊率。结果400例乳腺肿块患者经病理诊断，恶性肿块133例，占33．25％，良性肿块267例，占66．75％。二维超声组在乳腺恶性肿块中诊断敏感度为94．74％，特异度为98．50％，多普勒超声组在乳腺恶性肿块中诊断敏感度为91．73％，特异度为98．88％。多普勒超声检查良性肿块Vmax、PI、RI水平均低于恶性肿块[（12．4±4．1）cm／s vs（28．1±5．4）cm／s，（1．1±0．1）vs（1．8±0．2），（0．54±0．08）vs（0．81±0．10），P〈0．05]。两组患者在乳腺恶性肿块中诊断的阳性率、误诊率、漏诊率比较，差异均无统计学意义（P〉0．05）。结论二维超声和多普勒超声在乳腺良恶性肿块鉴别诊断中具有较高的敏感度和特异度，通过声像图、血流特点可对良恶性肿块作出有效鉴别诊断。

Objective To investigate the value of two-dimensional ultrasound and Doppler ultrasound in the differential diagnosis of breast masses.Methods Altogether 400 patients with breast masses treated in our hospital from January 2013 to December 2015 were selected as research object,all patients were divided into two-Dimensional ultrasound group and Doppler ultrasound group according to the different diagnosis methods,two-：dimensional ultrasonography and color Doppler uhrasonography were adopted respectively.Pathological diagnosis results were taken as the gold standard to determine sensitivity and specificity of two-dimensional ultrasound and Doppler ultrasound in the diagnosis of malignant breast masses,positive rate,misdiagnosis rate and missed diagnosis rate were compared between two groups.Results Among 400 cases of breast masses,133 cases were pathologically diagnosed as malignant tumors,accounting for 33.25%;267 cases were diagnosed as benign tumors,accounting for 66.75%.The diagnostic sensitivity and specificity of two-dimensional ultrasound group in breast malignant tumors was 94.74% and 98.50% respectively,the diagnostic sensitivity and specificity of Doppler ultrasound group in breast malignant tumors was 91.73% and 98.88% respectively. Peak systolic velocity （Vmax）,pulsatility index （PI） and resistive index （RI） levels of Doppler ultrasonography in diagnosis of benign masses were lower than those of malignant masses [（12.4±4.1） cm/s vs （28.1±5.4） cm/s,（1.1±0.1） vs （1.8± 0.2）,（0.54±0.08） vs （0.81±0.10）,P〈0.05].There was no statistically significant difference between the positive rate,misdiagnosis rate and missed diagnosis rate of two groups （P〉0.05） in the diagnosis of malignant breast mass.Conclusion Two-dimensional ultrasound and Doppler ultrasound demonstrate its features of high sensitivity and specificity,and can be used effectively in the differential diagnosis of benign and malignant breast mass through ultrasonography and blood flow characteristics.