不同超声弹性成像定量技术对乳腺病变的诊断价值

Diagnostic Value of Different Ultrasound Elastography Quantitative Techniques for Breast Lesions

目的:探讨压迫式弹性成像(CE)与声脉冲辐射力成像(ARFI)两种不同超声弹性成像定量技术对乳腺病变的诊断价值。方法:选取120例乳腺病变患者的临床资料,均行常规超声联合CE、ARFI检查,检查后均经术后活检与病理学诊断确诊。与手术病理确诊结果为对照,比较CE、ARFI诊断良恶性的敏感性、特异性、准确性及阳性、阴性预测值。结果:CE诊断中,7例良性误诊为恶性,9例恶性诊断为良性;ARFI诊断中,4例良性误诊为恶性,6例恶性诊断为良性;CE误诊的16例患者中有5例经ARFI准确鉴别。ARFI对乳腺病变良恶性鉴别诊断的敏感性94.44%、特异性87.50%、准确性91.67%、阳性预测值91.89%、阴性预测值91.30%,均明显高于CE鉴别诊断的90.28%、81.25%、86.67%、87.83%、84.78%。结论:CE、ARFI用于乳腺病变的良恶性鉴别诊断具有较高的敏感性、特异性、准确性、阳性预测值、阴性预测值,均具有较高的诊断价值,ARFI诊断效果优于CE。

Objective:To investigate the diagnostic value of compressive elastography(CE)and acoustic pulsed radiation force imaging(ARFI)two different ultrasound elastography quantitative techniques for breast lesions.Method:The clinical data of 120 patients with breast lesions were selected,routine ultrasound combined with CE and ARFI,after the examination,the diagnosis was confirmed by postoperative biopsy and pathological diagnosis.Compared the results of surgical pathological diagnosis,the sensitivity,specificity,accuracy,and positive and negative predictive value of CE and ARFI in the diagnosis of benign and malignant were compared.Result:In the diagnosis of CE,7 cases were benignly misdiagnosed as malignant and 9 cases were diagnosed as benign.In the diagnosis of ARFI,4 cases were misdiagnosed as benign and 6 cases were diagnosed as benign.Five of the 16 patients misdiagnosed by CE were accurately identified by ARFI.The sensitivity of ARFI in differential diagnosis of benign and malignant breast lesions was 94.44%,specificity was 87.50%,accuracy was 91.67%,positive predictive value was 91.89%,and negative predictive value was 91.30%,which were significantly higher than CE differential diagnosis of 90.28%,81.25%,86.67%,87.83%,84.78%.Conclusion:CE,ARFI for the differential diagnosis of benign and malignant breast lesions has higher sensitivity,specificity,accuracy,positive predictive value,negative predictive value,has a higher diagnostic value,ARFI diagnostic effect is better than CE.