多普勒超声和弹性成像技术在良恶性乳腺肿块诊断中的临床价值

Clinical value of Doppler ultrasound and ultrasound elastography in diagnosis of benign and malignant breast mass

目的探讨多普勒超声和超声弹性成像检查在良恶性乳腺肿块诊断中的临床应用价值。方法分别采用多普勒超声和超声弹性成像对该院2013年9月至2015年9月就诊的女性乳腺占位性病变典型患者136例进行检查,两者的结果与超声引导下乳房旋切穿刺针活检术后病理结果对比,通过二者与术后标本病理诊断符合率,评价两种检查方法的临床价值。结果 136例患者的多普勒超声检查结果为乳腺良性肿块126例,恶性肿块10例;超声弹性成像的检查结果为乳腺良性肿块121例、恶性肿块15例;乳腺旋切活检术行病理活检显示乳腺良性肿块118例,恶性肿块18例。超声弹性成像检查和多普勒超声检查对乳腺肿块进行诊断时,病变的ROC曲线下面积分别为0.825、0.779,二者比较,差异有统计学意义(Z=2.693,P<0.05)。结论多普勒超声检查对乳腺良性肿块的诊断准确率较高,但对恶性肿块的漏诊率较高,而超声弹性成像检查对诊断恶性肿块的准确率较高,对良性肿块中血流信号紊乱的肿块易误诊,故2种方法联合使用,能更好地诊断疾病、为临床诊治提供可靠依据。

Objective To investigate the clinical application value of Doppler ultrasound and ultrasound elastography in the diagnosis of benign and malignant breast mass. Methods Doppler ultrasound and ultrasound elastography were used to per- form the examination in 136 patients with typical space-occupying lesion in our hospital from September 2013 to September 2015. The examined results were compared with the pathological resuhs after ultrasound-guided breast rotary cutting needle biopsy. The clinical value of the two methods was evaluated by using the coincidence rate of their results to postoperative speci- men pathological diagnosis. Results The accuracy of Doppler ultrasound examination was lower than that of ultrasound elastog- raphy. Conclusion Doppler ultrasound examination has higher accuracy in the diagnosis of benign breast mass,but higher missed diagnosis rate of malignant mass, while ultrasound elastography has higher accuracy for diagnosing malignant mass and is easier to misdiagnosing the mass of blood flow signal disorder in benign masses, so the combined use of two methods used can better diagnose the disease and provide a reliable basis for clinical diagnosis and treatment.