超聲彈性成像對(duì)乳腺腫塊良惡性的鑒別診斷價(jià)值.pdf

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1、第44卷第1期第114頁(yè)華中科技大學(xué)學(xué)報(bào)(醫(yī)學(xué)版)V0I．44NO．1P．1142O15年2月ActaMedUnivSciTechnolHuazhongFeb．2015超聲彈性成像對(duì)乳腺腫塊良惡性的鑒別診斷價(jià)值吳梓芳，陳天亮武漢大學(xué)醫(yī)院超聲診斷科，武漢430072山東省濟(jì)寧醫(yī)學(xué)院附屬醫(yī)院超聲診斷科，濟(jì)寧272000摘要：目的評(píng)價(jià)超聲彈性成像(ultrasoundelastography，UE)對(duì)乳腺腫塊良惡性的鑒別診斷價(jià)值。方法收集180例患有乳腺實(shí)性腫塊女性患者的臨床資料，對(duì)180個(gè)乳腺實(shí)性腫塊分別進(jìn)行術(shù)前常規(guī)超聲(ultrasound，US)和UE檢查，對(duì)腫塊的

2、良惡性進(jìn)行初步判斷，以手術(shù)后組織病理結(jié)果作為標(biāo)準(zhǔn)，比較兩種診斷方法的診斷符合率和ROC曲線特征值。結(jié)果UE正確診斷出48例良性和127例惡性腫塊，US正確診斷出38例良性和J12例惡性腫塊，UE對(duì)乳腺腫塊良惡性診斷的靈敏度、特異度、準(zhǔn)確度、陽(yáng)性預(yù)測(cè)值與陰性預(yù)測(cè)值均高于US，差異具有統(tǒng)計(jì)學(xué)意義(均P<0．oa)；UE組的ROC曲線下面積AUC值為0．926，高于常規(guī)超聲組的AUC值0．899，差異有統(tǒng)計(jì)學(xué)意義(Z一2．8，P<0．05)。結(jié)論UE在乳腺腫塊良惡性的鑒別診斷中具有高靈敏度、特異度和準(zhǔn)確度等特點(diǎn)，應(yīng)用價(jià)值高，但尚存在一定缺陷，在應(yīng)用UE診斷乳腺疾病時(shí)，應(yīng)結(jié)

3、合US綜合評(píng)判。關(guān)鍵詞：超聲彈性成像；常規(guī)超聲；乳腺腫塊；鑒別診斷中圖分類號(hào)：R730．4DOI：10．3870／j．issn．1672—0741．2015．01．023UltrasoundElastographyintheDifferentialDiagnosisofBenignandMalignantBreastLesionsWuZifang．ChenTianliangDepartmentofMedicalUltrasound，HospitalofWuhanUniversity，Wuhan430072，China。DepartmentofMedicalUltra

4、sound，AffiliatedHospitalofJiningMedicalUniversity0_，、ShandongProvince，Jining272000，ChinaAbstractObjectiveToassessthevalueofultrasoundelastography(UE)inthedifferentia1diagnosisofbenignandma—lignantbreastmasses．MethodsClinicaldataof180femalepatientswithbreastmasseswerecollected．Atotalof1

5、8Omassesinthesepatientsweredetectedbyultrasound(US)andUEtOprimarilyidentifythebenignormalignantmassesbeforesurgery．ThediagnosticcoincidencerateandvaluesofR0Ccurvewerecomparedbasedonthepostoperativepathologicresultsbetweenthetwodiagnosismethods．ResultsForty-eightbenignmassesand127malign

6、antmasseswerecorrectlydiagnosedbyUE，and38benignmassesand112malignantmassesbyUS．Thesensitivity，specificity，accuracy，positivepredictivevalueandnegativepredictivevaluewerehigherinUEgroupthaninUSgroup，andthereweresignificantstatistica1differences(P

7、dertheROCcurve(AUC)inUEgroupwas0．926，significantlyhigherthanthatinUSgroup(O．899)(Z一2．8，P％0．05)．ConclusionUEhastheadvantagesofhighsensitivity，specificityandaccuracyindifferentialdiagnosisofthenatureofbreastmasses．IntermsofsomedisadvadtagesofUE，UEshouldbe,combinedwithUSinthediagnosisof