彩色多普勒超声联合实时弹性成像技术对乳腺小结节的诊断价值

Diagnostic value of color Doppler ultrasound combined with real time elastography for small breast nodules

目的探讨彩色多普勒超声联合实时弹性成像技术在"两癌"筛查中对乳腺结节的诊断价值。方法选取东莞市东城医院2015-2016年"两癌"筛查中发现的217例乳腺良恶性肿瘤患者,病理诊断结果显示良性结节患者184例,乳腺癌患者33例,采用彩色多普勒超声联合实时弹性成像技术诊断乳腺结节的良恶性,并与病理诊断结果作比较;采用改良的超声弹性成像5分法判断乳腺结节良恶性的准确性。结果与病理诊断结果比较,彩色多普勒超声联合实时弹性成像技术诊断乳腺癌的灵敏度为81.8%,特异度为82.1%,正确指数为0.639,假阳性率为17.9%,假阴性率为18.2%。超声弹性成像评分≥4分时,恶性结节比例为78.8%,明显高于良性结节的16.8%,差异有显著统计学意义(P<0.01)。结论彩色多普勒超声联合实时弹性成像技术对乳腺良恶性结节的诊断价值较高,可较准确地鉴别乳腺结节的良恶性,值得临床推广应用。

Objective To discuss the diagnostic value of color Doppler ultrasound combined with real time elastography for breast nodules in＂breast cancer and thyroid cancer screening＂. Methods A total of 217 cases with benign and malignant tumor of breast founded by the＂breast cancer and thyroid cancer screening＂in Dongguan Dongcheng Hospital from 2015 to 2016 were selected. Pathological diagnosis showed that there were 184 benign nodules and 33 malignant nodules. Ultrasound elasticity imaging technique was used to diagnose the benign and malignant nodule of breast, and its result was compared with pathological diagnosis result. 5-point method of modified ultrasound elasticity imaging was used to judge the accuracy of benign and malignant nodule of breast. Results Compared with pathological diagnose, the sensitivity of ultrasound elastogrephy in the diagnosis of malignant nodule was 81.8%, with the specificity of 82.1%, the correct index of 0.639, the false negative rate of 17.9% and the false positive rate of 18.2%.When ultrasound elastography score ≥ 4 points, the ratio of malignant nodule was 78.8%, which was significantly higher than 16.8% of benign nodule（P〈0.01）. Conclusion The diagnostic value of color Doppler ultrasound combined with real time elastography in the diagnosis of benign and malignant nodule of breast is higher, which can accurately identify the benign and malignant nodule of breast, and is worthy of wide popularization and application.