超声弹性应变率比值法与评分法鉴别乳腺结节良恶性的临床研究

A comparative study on the clinical effect of ultrasonic elastic strain rate ratio method and scoring method in differential diagnosis of benign and malignant breast nodules

目的探讨超声弹性应变率比值法与评分法在乳腺结节良恶性鉴别的临床价值。方法选取乳腺结节良恶性患者270例,入选患者均经手术病理确诊。患者入院后对病灶部位采用超声弹性成像进行检查,使用改良5分法对肿块进行评分,测定肿块与周围组织之间的弹性应变率比值,将测定结果与手术病理结果进行比较。结果 260例患者确诊为恶性肿瘤者108例,其中浸润性导管癌82例,乳头状癌8例,导管原位癌10例,浸润性小叶癌6例,其他2例。162例良性肿瘤确诊为纤维腺瘤者131例,炎性病灶5例,复杂囊肿14例,纤维囊性增生12例。超声弹性应变率比值法与评分法鉴别比较,差异无统计学意义(P>0.05);超声弹性应变率比值法与评分法在1、2、5分病灶鉴别准确率比较,差异无统计学意义(P>0.05);超声弹性应变率比值法3、4分病灶鉴别准确率高于评分法,差异有统计学意义(P<0.05)。超声弹性应变率比值法敏感性和特异性高于评分法(P<0.05)。结论乳腺结节良恶性患者采用超声弹性应变率比值法与评分法鉴别效果良好,能提高确诊率,具有临床价值。

Objective To observe the clinical effect of ultrasonic elastic strain rate ratio method and grading method in differenti- al diagnosis of benign and malignant breast nodules. Methods 270 patients with benign and malignant breast nodules were en- rolled. All patients were diagnosed by pathology. The patients were examined by ultrasonography after the admission, and the lesion ratio was compared with the surrounding tissue by the improved 5-point method. The results were compared with the results of op- eration and pathology. Results Of the 260 patients, 108 were diagnosed as malignancies,including 82 invasive ductal carcinoma,8 papillary carcinoma, 10 ductal carcinoma in situ, 6 invasive lobular carcinoma and 2 others. 162 cases of benign tumors,of which 131 cases of fibroadenoma,5 cases of inflammatory lesions, 14 cases of complex cysts, 12 cases of fibrocystic hyperplasia（P〉0.05）. There was no significant difference in the accuracy of ultrasound elastic strain rate ratio and score between 1,2 and 5 points（P〉 0.05）, but there was no significant difference between the two methods（P〈0.05）. The accuracy of the three-point and four-point discrimination was higher than the score（P〈0.05）. The sensitivity and specificity of the method were higher than those of the sco- ring method（P〈0.05）. Conclusion Ultrasonographic strain rate ratio method and scoring method are the best method for the diagnosis of benign and malignant breast nodules, which can improve the clinical diagnosis rate and provide the basis for clinical treatment.