超声弹性成像、常规超声与钼靶X线在乳腺肿瘤诊断中的价值

Diagnosetic value of ultrasonic elastography,conventional ultrasound and mammography in breast tumors

目的探讨超声弹性成像、常规超声与钼靶X线诊断乳腺肿瘤的价值。方法回顾分析2010年6月—2013年6月经手术病理证实的235例乳腺肿瘤患者（288个病灶）,分别分析超声弹性成像、常规超声、钼靶X线及三者联合应用诊断乳腺肿瘤的灵敏度、特异度、准确性。计数资料比较采用χ~2检验,P〈0.05为差异有统计学意义。结果超声弹性成像诊断乳腺肿瘤的灵敏度为84.21%（96/114）、特异度为83.33%（145/174）、准确性为83.68%（241/288）;常规超声诊断乳腺肿瘤的灵敏度为83.33%（95/114）、特异度为81.03%（141/174）、准确性为81.94%（236/288）;钼靶X线诊断乳腺肿瘤的灵敏度为77.59%（135/174）、特异度为74.56%（85/114）、准确性为76.39%（220/288）。超声弹性成像检查的准确性高于钼靶X线检查,差异有统计学意义（χ~2=4.791,P〈0.05）。三者联合诊断乳腺肿瘤的灵敏度为92.98%（106/114）、特异度为94.25%（164/174）、准确性为93.75%（270/288）。结论超声弹性成像鉴别乳腺良恶性的准确性高,弥补了常规超声及钼靶X线对乳腺肿瘤诊断的不足。

Objective To investigate diagnostic value of ultrasonic elastography, conventional ultrasound and mammography in breast tumors. Methods Retrospective analysis of 235 cases were pathologically confirmed, including 288 surgical lesions. Count data was used by chi square test, P〈0.05 was considered statistically significant. Results For ultrasonic elastography in diagnosis of breast tumors, the sensitivity, specificity and accuracy were 84.21%（96/114）, 83.33%（145/174）, 83.68%（241/288）, For conventional ultrasound in diagnosis of breast tumors, the sensitivity, specificity and accuracy were 83.33%（95/114）, 81.03%（141/174）, 81.94%（236/288）. For mammography in diagnosis of breast tumors, the sensitivity, specificity and accuracy were 77.5%（135/174）, 74.56%（85/114）, 76.39%（220/288）. The accuracy of ultrasonic elastography significantly greater than mammography（x^2=4.791, P〈0.05）.The sensitivity, specificity and accuracy of combined diagnosis by three methods on breast lesions were 92.98%（106/114）, 94.25%（164/174）, 93.75%（270/288）. Conclusion Ultrasonic elastography in diagnosis of breast malignant has high accuracy, which could make up for the lack of conventional ultrasound and mammography in the diangnosis of breast tumors.