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目的探讨乳腺弹性成像特征在乳腺结节良恶性鉴别诊断中的应用价值。方法搜集从2014年1月-2016年12月,242个使用乳腺弹性成像定量和半定量参数评估的乳腺结节(参数指标包括:弹性评分、应变率比值、结节最大直径比)。以术后病理结果为金标准。结果传统B型超声诊断良恶性结节敏感性和特异性分别为90%(95%可信区间CI,84~95)和60%(95%CI,48~72);弹性评分敏感性为98%(95%CI,92~99),特异性为46%(95%CI,33~60);应变率比值敏感性为81%(95%CI,71~89),特异性为70%(95%CI,56~81);结节最大直径比敏感性为64%(95%CI,53~75),特异性为76%(95%CI,62~86)。弹性成像指标联合应用要优于任何一种指标的单独应用。结论 B型超声联合弹性成像可显著提高乳腺结节的诊断效能,有较高的临床应用价值。
Objective To investigate the value of breast elastography in the differential diagnosis of benign and malignant breast nodules. Methods From January 2014 to December 2016, 242 breast nodules assessed using quantitative and semi-quantitative elastography of breast elastography (parameters included: elastic score, strain rate ratio, nodule maximum diameter ratio) were collected. Postoperative pathological results as the gold standard. Results The sensitivity and specificity of conventional B-mode ultrasound in the diagnosis of benign and malignant nodules were 90% (95% confidence interval CI 84-95) and 60% (95% CI 48-72) respectively. The sensitivity of the elastic score was 98 (95% CI, 92-99) and specificity of 46% (95% CI, 33-60). The sensitivity of strain rate was 81% (95% CI, 71-89) and specificity was 70% 95% CI, 56-81). The sensitivity of nodules was 64% (95% CI, 53-75) and specificity was 76% (95% CI, 62-86). Elastic imaging indicators combined application is superior to any one of the indicators alone. Conclusion B-mode ultrasound combined with elastography can significantly improve the diagnostic efficacy of breast nodules, and has high clinical value.