超声弹性成像在良恶性乳腺肿块鉴别中的应用价值

刘立江

摘 要 目的：探討乳腺肿块良恶性鉴别中超声弹性成像的应用价值。方法：收集2016年2月至2017年2月接诊的乳腺肿块患者80例。采用常规超声、超声弹性成像以及二者联合检查鉴别乳腺肿块良恶性的效果，并与病理检查结果进行比较。结果：病理检出恶性肿块15例，常规超声、超声弹性成像和二者联合检出恶性肿块分别为15例、14例和14例，三种超声检查方法差异无统计学意义（P>0.05）。超声弹性成像诊断恶性乳腺肿块的灵敏度、特异度、准确率、阳性预测值及阴性预测值分别为85.71%、92.42%、91.25%、70.59%和96.83%，常规超声分别为71.43%、83.33%、81.25%、47.62%和93.22%，差异无统计学意义（P>0.05）。联合检查的灵敏度、特异度、准确率、阳性预测值及阴性预测值分别为92.86%、96.97%、96.25%、86.67%和98.46%，其中特异度（χ2=6.911，P=0.009）、准确率（χ2=9.014，P=0.003）和阳性预测值（χ2=5.783，P=0.016）均高于常规超声。结论：超声弹性成像在鉴别乳腺肿块良恶性中效果略优于常规超声，二者联合检测效果最佳。

关键词 乳腺肿块；鉴别诊断；超声弹性成像

中图分类号：R737.9 文献标志码：A 文章编号：1006-1533（2018）16-0019-02

Application value of ultrasound elastography in the differentiation of benign and malignant breast tumors

LIU Lijiang

（Ultrasonography Department of Xiangyaping Mine Cooperation Hospital of Pingxiang， Jiangxi 337000， China）

ABSTRACT Objective： To explore the application value of ultrasound elastography in the differentiation of benign and malignant breast tumors. Methods： Eighty patients with breast tumors who were admitted from February 2016 to February 2017 were collected. Conventional ultrasound， ultrasound elastography and combination of the two were used to examine and identify benign and malignant breast tumors， and the results were compared with the results of pathological examination. Results： Fifteen cases of malignant tumor were detected by pathology. 15 cases， 14 cases and 14 cases were detected by conventional ultrasound， ultrasound elastography and combination of the two， respectively and there was no significant difference in the three methods of ultrasound examination（P>0.05）. The sensitivity， specificity， accuracy， positive predictive value and negative predictive value of ultrasound elastography in the diagnosis of malignant breast tumors were 85.71%， 92.42%， 91.25%， 70.59% and 96.83%， respectively， and those of conventional ultrasound were 71.43%， 83.33%， 81.25%， 47.62% and 93.22%， respectively， and the difference was not statistically significant（P>0.05）. The sensitivity， specificity， accuracy， positive predictive value and negative predictive value of the combined examination were 92.86%， 96.97%， 96.25%， 86.67% and 98.46%， respectively， and among them， the specificity（χ2=6.911， P=0.009）， accuracy（χ2=9.014， P=0.003） and positive predictive value（χ2=5.783， P=0.016） were all higher than those of conventional ultrasound. Conclusion： Ultrasound elastography is slightly superior to conventional ultrasound in the identification of benign and malignant breast tumors， and combined detection result is the best.

KEY WORDS breast tumor； differential diagnosis； ultrasound elastography

乳腺癌在女性恶性肿瘤中发病率较高，对女性的生命造成严重威胁[1]。常规超声是鉴别诊断乳腺肿块的首选方法，当常规超声发现肿块时，需根据肿块大小、形状、边界、回声等特点，进行肿块性质的判断[2]。超声弹性成像是一种新型的超声技术，可以提高常规超声诊断的准确性、敏感性和特异性[3]。本文报道在乳腺肿块良恶性鉴别中超声弹性成像的应用价值。

1 资料与方法

1.1 一般资料

收集2016年2月至2017年2月萍乡市湘雅萍矿合作医院接诊的乳腺肿块患者80例，年龄19～65岁，平均（48.55±7.64）岁，共发现肿块80个，经病理穿刺活检证实良性66枚，恶性14枚。