增强CT联合超声弹性成像鉴别乳腺小结节(直径≤2cm)性质的价值探究

Differential Value of Contrast-enhanced CT Combined with Ultrasound Elastography in Breast Nodules(diameter≤2cm)

目的探讨增强CT联合超声弹性成像(UE)鉴别乳腺小结节(直径≤2cm)性质的价值。方法选取2020年6月至2022年6月在本院就诊的350例乳腺小结节(直径≤2cm)为研究对象,所有患者入院后均进行增强CT扫描和UE检查,以手术病理结果为金标准,分析增强CT联合UE诊断乳腺小结节的诊断价值。结果350例患者经手术检出结节416个,其中良性结节262个,包括纤维腺瘤152个,纤维腺病57个,腺瘤22个,乳腺非典型增生19个,慢性炎症12个;恶性结节154个,包括浸润性乳管癌57个,腺癌26个,导管内癌伴浸润性小叶癌25个,导管内癌22个,浸润性小叶癌13个,原位癌5个,淋巴瘤5个。增强CT诊断恶性结节178例,良性结节238例;UE诊断恶性结节195例,良性结节221例;两者联合诊断恶性结节161例,良性结节255例。增强CT诊断良恶性结节的的灵敏度、特异度和准确度分别为76.62%、77.10%、76.92%,UE诊断良恶性结节的的灵敏度、特异度和准确度分别为88.96%、74.05%、79.57%,两者联合诊断良恶性结节的的灵敏度、特异度和准确度分别为74.03%、91.98%、85.34%,特异度和准确度均高于单一诊断方式(P<0.05)。结论增强CT联合UE诊断乳腺小结节(直径≤2cm)具有较高的诊断价值,可以为乳腺小结节的诊治提供参考。

Objective To explore the differential value of contrast-enhanced CT combined with ultrasound elastography(UE)in breast nodules(diameter≤2cm).Methods A total of 350 patients with breast nodules(diameter≤2cm)treated in the hospital were enrolled as the research objects between June 2020 and June 2022.All underwent contrast-enhanced CT scan and UE after admission.Taking the results of surgical pathology as the golden standard,the diagnostic value of contrast-enhanced CT combined with UE for breast nodules was analyzed.Results In the 350 patients,there were 416 nodules,including 262 benign nodules(152 fibroadenomas,57 fibroadenosis,22 adenomas,19 atypical breast hyperplasia,12 chronic inflammation)and 154 malignant nodules(57 invasive ductal carcinoma,26 adenocarcinoma,25 intraductal carcinoma with invasive lobular carcinoma,22 intraductal carcinoma,13 invasive lobular carcinoma,5 carcinoma in situ,5 lymphoma).Contrastenhanced CT showed that there were 178 malignant nodules and 238 benign nodules.UE showed that there were 195 malignant nodules and 221 benign nodules.The combined detection showed that there were 161 malignant nodules and 255 benign nodules.The sensitivity,specificity and accuracy of contrast-enhanced CT,UE and combined detection in the differential diagnosis of benign and malignant nodules were(76.62%,77.10%,76.92%),(88.96%,74.05%,79.57%)and(74.03%,91.98%,85.34%),respectively.The specificity and accuracy of combined detection were higher than that of single index(P<0.05).Conclusion Contrast-enhanced CT combined with UE has high diagnostic value for breast nodules(diameter≤2cm),which can provide reference for the diagnosis and treatment of breast nodules.