超声弹性成像及核磁共振成像的联合在乳腺良恶性肿物的临床应用

Clinical Diagnostic Value of Ultrasound Elastic Imaging and Nuclear Magnetic Resonance Imaging in Benign and Malignant Breast Masses

目的探讨超声弹性成像(ultrasonic elastography,UE)与核磁共振成像(magnetic resonance imaging,MRI)在乳腺良恶性肿物的诊断中的应用价值。方法对乳腺肿物的患者采取超声弹性成像与核磁共振检测法,得到对应的独立诊断结果。采用病理诊断数据充当金标准,确认单独及联合检查方式对乳腺肿物的诊断价值。结果病理诊断数据显示乳腺良性肿物31例,恶性肿物39例,采用超声成像诊断发现乳腺良性肿物37例,恶性肿物33例,采用核磁共振诊断发现乳腺良性肿物32例,恶性肿物38例,两类方法联合应用检测发现乳腺良性肿物29例,恶性肿物41例。UE、MRI与UE联合MRI对乳腺肿物检测的数据显示如下,灵敏度依次为76.9%、92.3%、97.4%,特异度依次为90.3%、93.5%、90.3%,准确率依次为82.9%、92.9%、94.3%,阳性预测值依次为90.9%、94.7%、92.7%,阴性预测值依次为75.7%、90.6%、96.6%,Kappa系数依次为0.659、0.856、0.883,ROC曲线下面积(area under the ROC,AUC)依次为0.836、0.929、0.939,得出联合方案和UE之间对比差异具有统计学价值,与MIR比较差异不具有统计学价值,对比三类方法的AUC值,联合方案优于UE及MIR,UE与MRI、联合方案差异均具有统计学价值。结论UE联合MIR法对乳腺肿物的良恶性诊断及鉴别诊断中具有重大的临床意义。

Objective To investigate the application value of ultrasonic elastography(UE)and magnetic resonance imaging(MRI)in the diagnosis of benign and malignant breast masses.Methods Ultrasonic elastic imaging and nuclear magnetic resonance detection were used to obtain the corresponding independent diagnosis results for the patients with breast masses.Pathological diagnostic data were used as the gold standard to confirm the value of single and combined examination in the diagnosis of breast masses.Results Pathological diagnosis data showed that 31 cases of benign breast tumors and 39 cases of malignant breast tumors.37 cases of benign breast tumors and 33 cases of malignant breast tumors were diagnosed by ultrasound imaging,32 cases of benign breast tumors and 38 cases of malignant breast tumors were diagnosed by MRI,and 29 cases of benign breast tumors and 41 cases of malignant breast tumors were detected by the combined application of the two methods.The data of UE,MRI and UE combined MRI for breast mass detection showed as follows:sensitivity was 76.9%,92.3%,97.4%,specificity was 90.3%,93.5%,90.3%,accuracy was 82.9%,92.9%,94.3%,positive predictive value was 90.9%,94.7%,92.7%,negative predictive value was 75.7%,90.6%,96.6%,the Kappa coefficient was 0.659,0.856,0.883,respectively,and the area under ROC curve was 0.836,0.929 and 0.939 successively,indicating that the comparison difference between UE and the combination scheme was statistically significant,while the difference between UE and MIR was not statistically significant.By comparing the AUC values of the three methods,the combined scheme was superior to UE and MIR,and the differences between UE and MRI and combined scheme were statistically significant.Conclusion UE combined with MIR method has great clinical significance in the benign and malignant diagnosis and differential diagnosis of breast masses.