常规超声与自动乳腺全容积成像及多模态超声对乳腺非肿块样病变良恶性的鉴别价值研究

Differential value of routine ultrasound and automated breast ultra sound and multimodal ultrasound in benign and malignant non-mass breast lesions

目的探究常规超声、自动乳腺全容积成像(ABUS)与多模态超声对乳腺非肿块样病变良恶性的鉴别价值。方法选取2020年10月至2022年5月于景德镇市第一人民医院行影像学检查的80例乳腺非肿块样病变患者作为研究对象,所有研究对象均行常规超声、ABUS及多模态超声检查,以病理检查结果为金标准,比较不同检查方式鉴别乳腺非肿块样病变良恶性的结果,并分析不同检查方式鉴别乳腺非肿块样病变良恶性的灵敏度、特异度、准确度、阳性预测值、阴性预测值、Kappa值。结果病理检查结果显示,80例乳腺非肿块样病变患者诊断良性23例,恶性57例;常规超声诊断良性32例,恶性48例;ABUS诊断良性26例,恶性54例;多模态超声检查良性20例,恶性60例。多模态超声鉴别乳腺非肿块样病变良恶性的灵敏度、准确度、阴性预测值、Kappa值均明显高于常规超声、ABUS检查,差异有统计学意义(P<0.05),但阳性预测值、特异度比较差异无统计学意义;常规超声、ABUS检查的灵敏度、特异度、准确度、阳性预测值、阴性预测值比较差异无统计学意义。结论与常规超声、ABUS相比,多模态超声鉴别乳腺非肿块样病变良恶性效果更佳,可明显提高诊断准确度与灵敏度,可作为快速鉴别肿瘤良恶性应用于临床诊断和指导治疗。

Objective To explore the differential value of routine ultrasound,automated breast ultra sound(ABUS)and multimodal ultrasound in benign and malignant non-mass breast lesions.Methods A total of 80 patients with non-mass breast lesions who underwent imaging examinations in Jingdezhen First People's Hospital from October 2020 and May 2022 were selected as the research subjects,all underwent routine ultrasound,ABUS and multimodal ultrasound examinations,taking pathological examination results as the golden standard,results of different examination methods in the differential diagnosis of benign and malignant non-mass breast lesions were compared,and their sensitivity,specificity,accuracy,positive predictive value,negative predictive value and Kappa value were analyzed.Results The results of pathological examination showed that in the 80 patients with non-mass breast lesions,there were 23 benign cases and 57 malignant cases;routine ultrasound showed that there were 32 benign cases and 48 malignant cases,ABUS showed that there were 26 benign cases and 54 malignant cases,and multimodal ultrasound showed that there were 20 benign cases and 60 malignant cases.The sensitivity,accuracy,negative predictive value and Kappa value of multimodal ultrasound in differentiating benign and malignant breast non-mass-like lesions were significantly higher than those of conventional ultrasound and ABUS(P<0.05),but there was no significant difference in positive predictive value and specificity.There was no significant difference in sensitivity,specificity,accuracy,positive predictive value and negative predictive value between conventional ultrasound and ABUS.Conclusion Compared with routine ultrasound and ABUS,multimodal ultrasound is more effective in the differential diagnosis of benign and malignant non-mass breast lesions,which can significantly improve diagnostic accuracy and sensitivity,and it can be applied in clinical diagnosis and guidance treatment due to rapid identification of benign and malignant tumors.