钼靶和超声联合检查对乳腺良恶性病变的鉴别诊断价值

Differential diagnosis value of mammography combined with ultrasound for benign and malignant breast lesions

目的探讨钼靶和超声联合检查对乳腺良恶性病变的鉴别诊断价值。方法选取2017年6月至2018年7月间唐都医院收治的100例行钼靶和超声检查的乳腺病变患者,统计钼靶、超声单独检查及联合检查结果的鉴别诊断价值。结果患者共发现乳腺肿块100个,经病理确诊的乳腺良性肿块79个,恶性肿块21个。钼靶检查与病理诊断结果符合肿块81个(81. 0%),超声检查与病理诊断结果符合肿块86个(86. 0%),钼靶联合超声检查与病理诊断结果符合肿块97个(97. 0%)。钼靶、超声单独检查诊断符合率比较,差异无统计学意义(P> 0. 05),钼靶联合超声检查诊断符合率均高于钼靶和超声单独检查,差异均有统计学意义(均P <0. 05)。钼靶检查诊断乳腺良恶性病变的灵敏度和特异度分别为82. 3%和76. 2%,与病理诊断的Kappa值=0. 598,一致性中等。超声检查诊断乳腺良恶性病变的灵敏度和特异度分别为86. 1%和85. 7%,与病理诊断的Kappa值=0. 668,有高度一致性。钼靶联合超声诊断乳腺良恶性病变的灵敏度和特异度分别为97. 5%和95. 2%,与病理诊断的Kappa值=0. 862,一致性较高。结论钼靶、超声检查用于乳腺良恶性病变检查各有优缺点,可互为补充,二者联合检查有助于乳腺良、恶性病变的鉴别诊断。

Objective To analyze the differential diagnosis value of mammography combined with ultrasound for benign and malignant breast lesions. Methods A total of 100 patients with breast lesions detected by mammography and ultrasound at Tangdu Hospital from June 2017 to July 2018. The significance of single mammography and ultrasound and the combined diagnosis method of the two were calculated. Results A total of 100 breast masses were found in the 100 patients,and 79 benign breast masses and 21 malignant masses were confirmed by pathology. Eighty-one breast masses found by mammography were coincident the detection results of the pathology( 81. 0%),for ultrasound,it was 86( 86. 0%) and for the combined detection,it was 97( 97. 0%). There was no statistically significant difference in the diagnostic coincidence rate between mammography and ultrasound( P > 0. 05),and the diagnostic coincidence rate for mammography combined with ultrasound was significantly higher than single mammography or ultrasound( all P < 0. 05). The sensitivity and specificity of mammography in the diagnosis of benign and malignant breast lesions were 82. 3% and 76. 2%,respectively,the Kappa value with pathological diagnosis was 0. 598,and the coincidence was moderate. The sensitivity and specificity of ultrasound in the diagnosis of benign and malignant breast lesions were 86. 1% and 85. 7%,respectively,the Kappa value with pathological diagnosis was 0. 668,and the consistency was high. The sensitivity and specificity of mammography combined with ultrasound in the diagnosis of benign and malignant breast lesions were 97. 5% and 95. 2%,the Kappa value with pathological diagnosis was 0. 886,and the consistency was extremely high. Conclusion Mammography and ultrasound for breast examination have their own advantages and disadvantages,and they can complement each other. The combined examination of the two can help the differential diagnosis of benign and malignant breast lesions.