超声弹性成像在乳腺实性小肿块性质诊断及鉴别中价值研究.docVIP

超声弹性成像在乳腺实性小肿块性质诊断及鉴别中价值研究 　　[摘要] 目的 探讨超声弹性成像在乳腺小肿块性质诊断及鉴别诊断中的应用价值。 方法 方便选取并回顾该院于2014年1月―2016年1月收治的80例乳腺小肿块患者手术病理及超声资料，并加以分析。结果 80例患者术后病理结果显示恶性肿块31例、良性肿块49例。以病理结果为“金标准”，常规超声检查诊断乳腺小肿块性质的准确度为77.50%（62/80）、敏感度为77.42%（24/31）、特异度为77.55%（38/49）；超声弹性成像诊断准确度为91.25%（73/80）、敏感度为90.32%（28/31）、特异度为91.84%（45/49），差异有统计学意义（P0.05）；超声弹性成像评分中1～3分、4～5分评分结果与病理结果一致性程度极好（Kappa=0.86、0.78）。结论 超声弹性成像诊断乳腺小肿块性质具有较高的准确度、敏感度及特异度，仍需结合常规超声，可为临床诊治提供重要信息。 　　[关键词] 超声检查；弹性成像；乳腺疾病；乳腺肿块 　　[中图分类号] R737.9 [文献标识码] A [文章编号] 1674-0742（2016）06（b）-0190-02 　　[Abstract] Objective To investigate the application values of elastosonography in the qualitative and differential diagnosis of small solid breast lumps. Methods Convenient selection the post-operative pathological and ultrasonic data of 80 patients from January 2014 to January 2016 with small breast lumps were retrospectively analyzed. Results Among the 80 patients， 31 patients had malignant lumps and 49 had benign ones， as revealed by the post-operative pathological results. With pathological result as gold standard， the accuracy， sensitivity， and specificity of routine ultrasonography in diagnosis of small breast lumps were 77.50% （62/80）， 77.42% （24/31）， and 77.55% （38/49）， respectively； while those of elastosonography were 91.25% （73/80）， 90.32% （28/31）， and 91.84% （45/49）， respectively； and the differences were statistically significant （P0.05）. The elastosonography scores were excellently accordant with the corresponding pathological results （Kappa = 0.86 and 0.78 for 1-3 and 4-5， respectively）. Conclusion Elastosonography has high accuracy， sensitivity， and specificity in diagnosis of small breast lumps， and can provide important information for clinical diagnosis and treatment combined with routine ultrasonography. 　　[Key words] Ultrasonography； Elastosonography； Breast disease； Breast lump 　　乳腺实性肿块是乳腺疾病的临床体征之一，常见于乳腺癌、乳腺纤维腺瘤和乳腺增生等，病变性质不同，临床治疗方法存在较大差异。超声具有无创性、无放射和重复性好等特点，广泛应用于乳腺疾病检查中。常规超声主要通过观察乳腺肿块的边界、内部回声、后方衰减和微钙化等特征，判定乳腺肿块的性质，然而，乳腺肿块体积较小时（