【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-USⅣ级肿块更具诊断价值。更多还原

【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.更多还原