弹性成像对超声引导乳腺肿块穿刺活检指导价值

Value of elastography in the guidance of ultrasound-guided breast mass biopsy

目的分析弹性成像对超声引导乳腺肿块穿刺活检指导价值。方法选取2017年2月～2018年12月于我院接受常规超声及弹性成像检查的140例行乳腺肿块穿刺活检患者为研究对象,应用BI-RADS分级与弹性评分来对患者乳腺肿块的良恶性进行评价。结果病理检查显示,140例患者中良性病变68例(48.57%),其中纤维腺瘤43例(30.71%),导管内乳头状瘤12例(8.57%);恶性病变72例(51.43%),其中浸润性导管癌48例(34.29%);BI-RADS分级诊断后,敏感性为93.06%(67/72),特异度为61.76%(42/68),准确度为77.86%(109/140);弹性评分诊断后,敏感性为87.5%(63/72),特异度为89.71%(61/68),准确度为88.57%(124/140),两组敏感度差异无统计学意义(P>0.05),两组特异度与准确度的差异有统计学意义(P<0.05)。结论弹性评分不同的彩超评价4级以上的乳腺肿块,其临床决策需区别对待,以提高其诊断准确率。

Objective To explore the value of elastography in the guidance of ultrasound-guided breast mass biopsy.Methods A total of 140 patients with breast mass biopsy were enrolled.The patients underwent routine ultrasound and elastography from February 2017 to December 2018,and applied with BI-RADS classification and elasticity scores.The benign and malignant nature of the patient's breast mass were evaluated.Results Among 140 cases,68 cases (48.57%) were benign lesions,43 cases (30.71%) were fibroadenoma and 12 cases (8.57%) were intraductal papilloma.Malignant lesions were found in 72 cases (51.43%) and invasive ductal carcinoma in 48 cases (34.29%).After BI-RADS grading,the sensitivity,specificity and accuracy were 93.06%(67/72),61.76%(42/68) and 77.86%(109/140),respectively.After elastic score diagnosis,the sensitivity,specificity and accuracy were 87.5%(63/72),89.71%(61/68) and 88.57%(124/140),respectively.The difference of sensitivity was not significant (P>0.05).The difference of specificity and accuracy between groups was significant (P<0.05).Conclusion Color doppler ultrasound with different elasticity scores evaluates breast masses above grade 4.Its clinical decision-making needs to be treated differently to improve its diagnostic accuracy.