常规超声在非肿块型乳腺癌诊断中的应用及漏误诊分析

Application and Analysis of Missed Diagnosis and Misdiagnosis of Non Mass Breast Cancer by Conventional Ultrasound

目的:探讨常规超声在非肿块型乳腺癌诊断中应用效果,并分析其漏误诊情况。方法:回顾性分析2020年4月-2022年5月莆田市第一医院收治的86例经病理穿刺活检确诊乳腺癌患者临床资料,术前行磁共振、超声检查,术后行病理组织检查,以后者为诊断金标准。比较磁共振、超声对非肿块型乳腺癌诊断敏感度、特异度、准确率和非肿块型乳腺癌影像学特征检出率。结果:常规超声与磁共振诊断非肿块型乳腺癌的敏感度、特异度、准确率、误诊率、漏诊率比较,差异均无统计学意义(P=0.265、0.327、0.141、0.327、0.265)。常规超声对微钙化检出率、导管扩张检出率均高于磁共振(63.41%vs.29.27%、17.07%vs.0.00%,P=0.002、0.006)。结论:常规超声与磁共振诊断效能相一致,但常规超声在非肿块型乳腺癌微钙化、导管扩张征象检出中发挥显著优势。

Objective:To explore the effect of conventional ultrasound in the diagnosis of non mass breast cancer and analyze its misdiagnosis.Method:The clinical data of 86 patients with breast cancer confirmed by pathological puncture and biopsy received by Putian First Hospital from April 2020 to May 2022 were retrospectively analyzed,magnetic resonance and ultrasound examination were performed before the operation,and pathological tissue examination was performed after the operation,the latter was the gold standard for diagnosis.The diagnostic sensitivity,specificity,accuracy and detection rate of imaging characteristics of non mass breast cancer were compared between magnetic resonance and ultrasound.Result:There were no significant differences in sensitivity,specificity,accuracy,misdiagnosis rate and missed diagnosis rate of non mass breast cancer between conventional ultrasound and magnetic resonance(P=0.265,0.327,0.141,0.327,0.265).The detection rates of microcalcification and catheter dilation by conventional ultrasound were higher than those by magnetic resonance(63.41%vs.29.27%,17.07%vs.0.00%,P=0.002,0.006).Conclusion:Conventional ultrasound is consistent with magnetic resonance diagnostic performance,but conventional ultrasound plays a significant advantage in the detection of signs of microcalcification and catheter dilation in non mass breast cancer.