【摘要】 目的探讨超声弹性Itoh 5分评分法与应变率比值法在乳腺良恶性肿块鉴别中的应用价值。方法对经手术病理证实的131例患者共147个病灶进行了超声弹性成像检查,采用Itoh 5分评分法对肿块进行评分;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2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2种方法对乳腺肿块的诊断效率。结果良性75例共80个肿块,恶性56例共67个肿块,Itoh 5分评分法诊断乳腺良恶性病变的敏感性为74.6%,特异性为90.0%,准确性为83.0%;弹性应变率比值法诊断乳腺良恶性病变敏感性为92.5%,特异性为93.8%,准确性为93.3%。构建ROC曲线后,2种方法的曲线下面积(AUC)分别为:Itoh 5分评分法0.933,95%可信区间0.897～0.969;应变率比值法0.943,95%可信区间0.901～0.985。2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。结论运用超声弹性成像鉴别诊断乳腺良恶性病灶,应变率比值法较Itoh 5分评分法更具客观性,具有更高诊断价值。更多还原

【Abstract】 Objective To investigate the differentiation value of strain ratio measure method and 5-scoring system in breast benign and malignant solid lesions with ultrasonic elastography.Methods One hundred and thirty-one patients with 147 lesions were included in the study.The lesion were scored with Itoh scoring system and strain ratio measure method(3.08 as the cut-off point)respectively.According to pathologic diagnosis,the accuracy of the two methods was compared and the diagnostic performance of the two methods was evaluated with receiver operating characteristic curve(ROC).Results There were 75 benign and 67 malignant lesions.The sensitivity,specificity and accuracy of 5-scoring system in diagnosing malignant breast lesions were 74.6%,90.0%and 83.0%.The sensitivity,specificity and accuracy of strain ratio measure method were 92.5%,93.8%and 93.3%.The area under curve(AUC)of 5-scoring system was 0.933,and that of strain ratio measure method was 0.943.There was significant difference between the accuracy of 5-scoring system and strain ratio measure method(P<0.05).Conclusions Strain ratio measure method could provide more objective and higher value in diagnosing malignant breast lesions than 5-scoring system.更多还原