摘要
目的：比较BI-RADS-US诊断标准与弹性成像应变率比值对乳腺良恶性肿块的诊断价值。方法：对经手术病理证实的140例患者共159个肿块进行常规超声检查并按照BI-RADS-US标准诊断分级，再进行超声弹性成像检查，测定肿块与周围组织的弹性应变率比值，以弹性应变率比值≥3.08为界点判断肿块良恶性，以病理诊断结果为金标准，对比分析两种方法诊断乳腺肿块良恶性的准确度；构建受试者工作特征（ROC）曲线，比较两种方法对乳腺肿块的诊断效率。结果：良性78例共88个肿块，恶性62例共71个肿块，BI-RADS-US诊断乳腺良恶性病变的敏感性为91.55%（65/71），特异性为73.86%（65/88），准确性为81.76%（130/159）；弹性应变率比值诊断乳腺良恶性病变敏感性为94.37％（67/71），特异性为87.50％（77/88），准确性为90.56％（144/159）。构建ROC曲线后，两种方法的曲线下面积（AUC）分别为：BI-RADS-US诊断0.851，95%可信区间0.791~0.911；应变率比值诊断0.887，95%可信区间0.825~0.950。两种方法准确性的配对卡方McNemar检验结果P＜0.05，差异具有统计学意义。结论：超声弹性成像应变率比值测定鉴别乳腺良恶性肿块较BI-RADS-US诊断分级准确性高，对于BI-RADS-US Ⅳ级肿块更具诊断价值。
Abstract
Objective: To compare the diagnostic value of BI-RADS and ultrasonic elastography in the differentiation of breast lesions. Methods: 140 patients with 159 lesions were included in the study. The lesions were scored with BI-RADS and ultrasound elastography(UE) respectively. The pathologic diagnosis was the gold standard. The diagnostic performance of the 2 methods was evaluated with receiver operating characteristic(ROC) curve. Result: The areas under the curve(AUC) of the 2 methods were BI-RADS 0.851, UE 0.887. After ROC comparing, the diagnostic performance of UE was better than that of BI-RADS(P<0.05). The specificity and accuracy of UE were better than those of BI-RADS(P<0.05). Conclusions: The UE could improve the differentiation of breast lesions. The grade of Ⅳ in BI-RADS should be paid more attention.
关键词
乳腺肿瘤 /
乳腺疾病 /
超声检查 /
多普勒 /
彩色
Key words
Breast neoplasms /
Breast diseases /
Ultrasonography /
Doppler /
color
葛 晖;丁 中;王 矛;李成华;张 峰;陈 寒.
BI-RADS-US与弹性成像应变率比值对乳腺肿块的诊断价值[J]. 中国临床医学影像杂志. 2013, 24(1): 9-12
GE Hui;DING Zhong;WANG Mao;LI Cheng-hua;ZHANG Feng;CHEN Han.
Comparison of BI-RADS and ultrasonic elastography in differentiation of breast lesions[J]. Journal of China Clinic Medical Imaging. 2013, 24(1): 9-12
中图分类号：
Ｒ737.9
R655.8
Ｒ445.1
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