比较分析常规超声及乳腺X线摄影对不同类型乳腺肿块的诊断价值

Analysis of the diagnostic value of conventional ultrasound and mammography in different types of breast masses

目的:比较分析常规超声及乳腺X线摄影对不同类型乳腺肿块的诊断价值。方法:回顾并分析2013年1月—2019年8月于上海交通大学附属第一人民医院行乳腺超声及乳腺X线摄影检查的1600例患者资料。以病理学检查结果为金标准,探讨常规超声及乳腺X线摄影对不同类型乳腺肿块的诊断价值。结果:共有867个良性肿块,733个恶性肿块。非致密型乳腺491例,致密型乳腺1109例。常规超声对乳腺肿块诊断灵敏度显著高于乳腺X线摄影,乳腺X线摄影的诊断特异度高于常规超声,差异均有统计学意义(P<0.05)。对于致密型乳腺及年轻患者(≤40岁),常规超声诊断的灵敏度显著高于乳腺X线摄影,乳腺X线摄影特异度显著高于常规超声(P<0.05)。对于非致密型乳腺及>40岁患者,常规超声灵敏度高于乳腺X线摄影,乳腺X线摄影特异度高于常规超声,但差异均无统计学意义(P>0.05)。两种方法联合在不同年龄及不同乳腺类型患者中诊断的灵敏度均高于单一检查方法,而特异度低于单一检查方法,差异均有统计学意义(P<0.001)。结论:常规超声在致密型乳腺及年轻患者(≤40岁)中探测肿块的灵敏度显著高于乳腺X线摄影,而乳腺X线摄影的特异度更高。联合诊断在不同年龄及不同乳腺类型患者中对乳腺肿块诊断的灵敏度均高于单一检查方法。

Objective:To analyze the diagnostic value of conventional ultrasound and mammography in different types of breast masses.Methods:A retrospective analysis was performed on the data of 1600 patients who underwent both conventional ultrasound and mammography examination in Shanghai General Hospital,Shanghai Jiao Tong University from January 2013 to August 2019.Pathological results were used as the gold standard to investigate the diagnostic value of conventional ultrasound and mammography in different types of breast masses.Results:There were 867 benign masses and 733 malignant ones.Four hundred and ninety-one were non-dense and 1109 were dense.The sensitivity of conventional ultrasound was significantly higher than that of mammography,while the specificity of mammography was higher than that of conventional ultrasound.The difference was statistically significant(P<0.05).For dense breasts and young patients(≤40 years),the sensitivity of conventional ultrasound was significantly higher than that of mammography,and the specificity of mammography was significantly higher than that of conventional ultrasound(P<0.05).For non-dense breasts and patients over 40 years old,the sensitivity of conventional ultrasound was higher than mammography and mammography was more specific,but there was no statistical significance(P>0.05).The sensitivity of the combined diagnosis was higher than both of two single test methods,and the specificity was lower,whether in different ages or different types of breast,and the comparison was statistically significant(P<0.001).Conclusion:The sensitivity of conventional ultrasound in dense breasts and young patients (≤40 years) is significantly higher than that of mammography, and the specificity of mammography is higher. The combineddiagnosis is more sensitive to the diagnosis of breast masses than both of two single test methods, whether in different ages ordifferent types of breast.