超声弹性成像技术与乳腺X线摄影对乳腺良恶性肿块的诊断价值

Study on diagnostic value of ultrasound elastography and mammography in benign and malignant breast lesions

目的探讨超声弹性成像技术及乳腺X线摄影对乳腺肿块良恶性的诊断价值。方法收集82例患者共101个病灶,术前采用应变率比值法(SR)、声触诊组织量化(VTQ)技术和乳腺X线摄影检查,获得每个病灶的超声弹性参数值以及乳腺X线摄影BI-RADS分类,以手术的病理结果作为诊断标准,判断超声弹性成像技术及乳腺X线摄影对乳腺良恶性肿块的诊断价值。结果 SR诊断乳腺肿块良恶性的最佳截断值为3.12,其敏感度、特异度、准确性分别为90%、94%、91%,曲线下面积(AUC)为0.937;VTQ技术诊断乳腺良恶性肿块的最佳截断值为5.56 m/s,其敏感度、特异度、准确性分别为91%、97%、93%,AUC为0.961;乳腺X线摄影诊断乳腺良恶性肿块的敏感度、特异度、准确性分别为76%、77%、76%,AUC为0.767。超声弹性成像技术诊断乳腺良恶性肿块的曲线下面积大于乳腺X线摄影,且差异具有统计学意义。结论超声弹性成像技术和乳腺X线摄影均对乳腺良恶性肿块有一定的诊断价值,超声弹性成像技术对乳腺良恶性肿块的诊断效能优于乳腺X线摄影。

Objective To explore the diagnostic value of ultrasound elastography and mammography in benign and malignant breast lesions differentiation. Methods A total of 82 female breast patients with 101 breast nodules who had underwent SR,VTQ technique and mammography were selected. The stain rate ratio,shear wave velocity and mammography BI-RADS classification of the nodules were obtained. Pathological results were used as diagnosis standard to compare thevalue ofultrasound elastography and mammography in the diagnosis of benign and malignant breast lesions. Results The optimal cut-off values of SR in diagnosis of benign and malignant breast lesions is 3.12. Its sensitivity,specificity,accuracy and AUC are 90%,94%,91%,0.937.The optimal cut-off value of VTQ in diagnosis of benign and malignant breast lesions is 5.56 m/s. Its sensitivity,specificity,accuracy and AUC are 91%,97%,93%,0.961. The sensitivity,specificity,accuracy and AUC of the mammography in the diagnosis of the benign and malignant breast lesions were 76%,77% and 76%,0.767. The area under curve of ultrasound elastography in the diagnosis of benign and malignant breast masses is higher than that of mammography,and the difference is statistically significant. Conclusions Ultrasound elastography technique and mammography have a certain diagnostic value for benign and malignant breast diseases. Theability of Ultrasound elastography technique to diagnose benign and malignant breast diseasesis superior to mammography.