【摘要】 目的比较弹性应变率比值法以及Itoh评分法、改良5分法对大小不同的乳腺良恶性肿瘤的诊断价值。方法对手术病理证实269例患者共377个病灶(良性278个,恶性99个)进行了超声弹性成像(UE)检查,获得弹性成像图像后,以Itoh评分法、改良5分法分别对病灶进行评分;测量病灶与周围组织的弹性应变率比值,以3.08为界点判断病灶良恶性。以病灶最大径线分为3组,≤1cm组,>1～2cm组,>2cm组,构建受试者应用曲线,比较3种UE方法对不同大小乳腺肿物的诊断行为。病理诊断为金标准。结果构建ROC曲线并进行比较得出:≤1cm组3种诊断方法的诊断价值相似(P≥0.05);1～2cm组及>2cm组比值法与改良5分法对乳腺肿物的诊断价值相似(P≥0.05),优于Itoh5分法(P<0.05)。结论弹性应变率比值测量方法是一更为客观的UE诊断方法,对较大病灶的诊断优势更为突出,具有广阔的临床应用前景。更多还原

【Abstract】 Objective To compare the diagnostic value of strain ratio measure method and Itoh scoring system as well as improved 5-scoring system in differentiating breast benign and malignant solid lesions in different size. Methods 269 patients with 377 lesions (278 benign,99 malignant) were included in the study,Ultrasound sonography found the lesions,then ultrasonic elatography (UE) got the strain images. The lesions were scored with hoh scoring system,improved 5-scoring system. By strain ratio measure method equipped with the ultrasonic machine, strain index of the lesion was calculated, with 3.08 as the cut-off point. The pathologic diagnosis was as gold standard. Lesions were divided into 3 groups (≤1 cm,1 cm<and≤2 cm,>2 cm) according to the lesion size. The diagnostic performance of the 3 methods was evaluated with receiver operating characteristic curve (ROC). Results After ROC comparing,for ≤1cm group,the diagnostic performance of strain ratio measure method was almost the same as the three 5-scoring systems (P≥0.05). For 1 cm<and≤2 cm and>2 cm groups,the diagnostic performance of strain ratio measure method was almost the same as the improved 5-scoring systems (P≥0.05), better than Itoh system (P<0.05). Conclusions Strain ratio measure method could provide a more objective diagnostic standard for UE. And the advantages were obvious in diagnosing big solid breast lesions.更多还原