【摘要】 目的探讨超声实时应变成像技术在乳腺不同直径实性病灶中的应用价值。方法对直径≤10 mm的83个乳腺病灶(I组)和直径>10 mm的110个乳腺病灶(Ⅱ组)术前分别行弹性成像整体应变率(ESR)及局部应变率(LSR)2种测量方法检查。根据弹性成像检查结果,以手术病理为诊断金标准,构建2种测量方法的ROC曲线,分别获得最佳临界点。参考最佳临界点,分别计算ESR、LSR诊断(I组、Ⅱ组)乳腺良恶性病灶的敏感性、特异性、准确性和漏诊率。结果 ESR ROC曲线下面积(AUC)为0.904±0.024,最佳临界点为3.06,判定乳腺良恶性病灶的敏感性、特异性、准确性和漏诊率分别为:I组为90.5%、96.8%、95.2%和9.5%,Ⅱ组为78.4%、84.9%、82.7%和21.6%。LSR的AUC为0.944±0.019,最佳临界点为31.26,判定乳腺良恶性病灶的敏感性、特异性、准确性和漏诊率分别为:I组为95.2%、98.4%、97.6%和4.8%,Ⅱ组为83.8%、91.8%、89.1%和16.2%。结论 (1)超声实时应变成像技术有助于乳腺小实性病灶的良恶性鉴别;(2)LSR对乳腺大实性病灶的良恶性鉴别优于ESR。更多还原

【Abstract】 Objective To explore the clinical value of quantitive ultrasound elastography for different diameter benign and malignant breast solid lesions.Methods Eighty-three small breast lesions(diameter≤10 mm,groupⅠ)and 110 large breast lesions(diameter>10 mm,groupⅡ)were preoperation examined with entire strain ratio(ESR)and localized strain ratio(LSR)methods respectively.According to results of UE,pathology was as golden standard for diagnosis, receiver operating characteristic(ROC)curves were used to explore the optimized cut-off points respectively,according to optimized cut-off points,and the sensitivity,specificity,accuracy and failure rate of ESR and LSR for diagnosing breast solid lesions(groupⅠ,Ⅱ)were calculated respectively.Results For ESR study,ROC curves revealed an area under the curve of 0.904 + 0.024,the optimized cut-off point was 3.,06,and the sensitivity,specificity,accuracy, failure rate for diagnosing breast lesions was 90.5%,96.8%,95.2%,9.5%in group I and 78.4%,84.9%,82.7%, 21.6%in groupⅡ,respectively,while those of LSR study was 0.944 + 0.013,31.26,95.2%,98.4%,97.6%,4.8% in groupⅠand 83.8%,91.8%,89.1%,16.2%in groupⅡ,respectively.Conclusions Quantitive ultrasound elastography (Both ESR and LSR)is helpful in differentiating breast small lesions.LSR is superior to ESR in differentiating breast large lesions.更多还原