【摘要】 目的通过对比准静态弹性成像三种诊断方法的诊断效能,找到最佳的诊断方法,提高诊断准确性。方法对523例(652个病灶)乳腺占位患者行常规超声及超声弹性成像检查,先用5分评分法联合常规超声得出诊断结论,然后测量病灶的面积比值及应变率比值,以病理结果作为参考标准,构建受试者操作特性曲线(receiver-operating characteristic,ROC),得出判断乳腺良恶性病变的曲线下面积(AUC),最佳截断值(cutoff value)。结果面积比值法和应变率比值法AUC及cutoff值分别为:0.850、1.43;0.907、3.35。5分法、面积比值法和应变率比值法敏感性、特异性、准确性分别为:96.23%、87.05%、88.65%;90.63%、78.81%、86.35%;92.31%、74.58%、85.59%。评分法、面积比值法、应变率比值法诊断准确性两两比较无统计学差异(P>0.05)。结论 5分法、面积比值法和应变率比值法诊断准确性无统计学差异,但各具优势,应视具体情况灵活运用,以提高诊断准确性。更多还原

【Abstract】 Objective By comparing the diagnostic efficacy of three kinds of diagnostic methods,we hoped to find the best method to improve the accuracy of diagnosis. Methods The 652 breast lesions from 523 women were undergoing conventional ultrasound and real-time tissue elastography,diagnostic results were obtained with 5-score method in conjunction with conventional ultrasound. Then,we measured the lesion of the area ratio and strain ratio,the pathological results as the reference standard to construct test receiver operating characteristic curve(ROC),and the area under the curve and the optimal cut-off value of benign and malignant breast lesions diagnosis were got. Results The area under the curve and cutoff values of area ratio and strain ratio were 0. 850,1. 43; 0. 907,3. 35 respectively. The sensitivity,specificity,accuracy of 5-score method,strain ratio method and area ratio method were 96. 23%,87. 05%,88. 65%; 92. 31%,74. 58%,85. 59%; 90. 63%,78. 81%,86. 35% respectively.The 5-score method,area ratio method,strain ratio method diagnostic accuracy had no statistical difference(P > 0. 05). Conclusion 5-score method,area ratio method and strain ratio method had no significant difference in diagnostic accuracy,each method had respective advantages,it should be used flexible with the specific circumstances to improve the accuracy of diagnosis.更多还原