多模态超声对乳腺非肿块样病变的诊断价值

The efficacy of multi-modal ultrasound in diagnosis of non-mass breast lesions

目的 超声较易分辨典型的乳腺肿块,但对于乳腺非肿块样病变的诊断目前研究较少。文中旨在分析乳腺非肿块样病变的超声表现,探究多模态超声对乳腺非肿块样病变的诊断效能,以提高诊断准确性。方法 回顾性分析2019年6月至2020年12月江苏省肿瘤医院超声科收治的62例乳腺非肿块样病变患者临床资料。采用常规超声、自动乳腺全容积成像(ABUS)、多模态超声进行诊断。与病理结果对照,探究多模态超声检查的准确度、敏感度、特异度、阳性预测值和阴性预测值。结果 62例病灶中,病理诊断为良性18例、恶性44例。以病理诊断为金标准进行诊断试验结果显示,常规超声诊断、ABUS检测和多模态超声等三种超声诊断结果一致性检验均具有统计学意义(P<0.05),其kappa值分别为0.337、0.499和0.531,依次升高。多模态超声的诊断准确度、敏感度和特异度分别为82.26%、83.67%和76.92%,阳性预测值和阴性预测值为93.18%和55.56%。结论 多模态超声的诊断敏感度和特异度等指标优于常规超声诊断、ABUS检测,其对乳腺非肿块样病变具有较高的临床诊断意义。

Objective Classical breast mass can be identified easier by ultrasound, yet research about the diagnosis of non-mass lesions(NMLs) are scarce. This study aimed to explore the ultrasonic manifestations of non-mass breast lesions and evaluate the efficacy of multi-modal ultrasound for non-mass lesions in a bid to improve the diagnostic accuracy. Methods The clinical data of 62 patients with NMLs who admitted in the Jiangsu Cancer Hospital from June 2019 to December 2020 was collected. Conventional ultrasound, the automated breast ultrasound system(ABUS) and multi-modal ultrasound were performed. The accuracy, sensitivity, specificity, positive and negative predictive value of multi-modal ultrasound were investigated by comparing with the pathological results.Results Of 62 cases, 18 cases were pathologically benign and 44 cases malignant. By methods of diagnostic test, the consistency of conventional ultrasound diagnosis, ABUS detection and multi-modal ultrasound diagnosis results between pathological results were statistically significant respectively(all P<0.05), and the kappa values were 0.337, 0.499 and 0.531 respectively. The accuracy, sensitivity, specificity, positive predictive value and negative predictive value of multi-modal ultrasound were 82.26%, 83.67%, 76.92%,93.18% and 55.56%. Conclusion With higher sensitivity and specificity than the conventional ultrasound and ABUS detection, the use of multi-modal ultrasound in the diagnosis of patients with non-mass lesions of the breast has a good diagnosis value.