超声影像在肉芽肿性乳腺炎诊断中的应用价值分析

Analysis of the application value of ultrasonic image in the diagnosis of granulomatous mastitis

目的:探讨超声影像在肉芽肿性乳腺炎诊断中的应用价值。方法:选取2020年1月—2022年12月昆山市第二人民医院收治的82例疑似肉芽肿性乳腺炎(idiopathic granulomatous mastitis,IGM)患者,均行超声影像检查,以病理穿刺活检结果为金标准,分析超声影像对IGM的诊断效能;比较结节型、片状低回声型、弥散型三种类型的超声图像特征。结果:病理穿刺活检结果显示,阳性55例,阴性27例;超声影像结果显示,阳性54例(真阳52例,假阳2例),阴性28例(真阴25例,假阴3例);超声影像对IGM的诊断灵敏度为94.55%、特异度为92.59%、准确率为93.90%、阳性预测值为96.30%、阴性预测值为89.29%,Kappa=0.863,与病理结果高度一致;片状低回声型、弥散型多形态不规则、边界不清晰,大多有小囊状或管状回声,而结节型形态以圆形或椭圆形为主,边界多清晰,多无小囊状及管状回声,不同分型差异有统计学意义(P<0.05),三种分型在纵横比、蟹足毛刺征、内部回声、点状强回声、后方回声、血流分级、弹性评分方面差异无统计学意义(P>0.05)。结论:超声影像在IGM中的诊断价值显著,诊断效能高,且能有效鉴别结节型、片状低回声型、弥散型三种分型。

Objective To explore the value of ultrasonography in the diagnosis of granulomatous mastitis.Methods A total of 82 patients with suspected idiopathic granulomatous mastitis(IGM)admitted to Kunshan Second People's Hospital from January 2020 to December 2022 were selected for ultrasonography,with pathological puncture biopsy as the gold standard.To analyze the diagnostic efficacy of ultrasonic imaging for IGM.The characteristics of three types of ultrasonic images were compared:nodular,flaky hypoechoic and diffuse.Results Pathological puncture biopsy results showed that 55 cases were positive and 27 cases were negative.The results of ultrasonic imaging showed that 54 cases were positive(52 cases of true positive,2 cases of false positive)and 28 cases were negative(25 cases of true negative,3 cases of false negative).The diagnostic sensitivity of ultrasonic imaging for IGM was 94.55%,specificity 92.59%,accuracy 93.90%,positive predictive value 96.30%,negative predictive value 89.29%,Kappa=0.863,which was highly consistent with pathological results.The flaky hypoechoic type and diffuse type had irregular shape and unclear boundary,and most of them had small cystic or tubular echo,while the nodular type was mainly round or oval in shape,with clear boundary and no cystic or tubular echo,there were statistically significant differences between different subtypes(P<0.05).There were no statistically significant differences in aspect ratio,crab foot burr sign,internal echo,punctiform strong echo,rear echo,blood flow grading and elasticity score among the three types(P>0.05).Conclusion The diagnostic value of ultrasound image in IGM is significant and the diagnostic efficiency is high.Moreover,it can effectively distinguish the nodular type,the flaky hypoechoic type and the diffuse type.