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目的对比分析超声弹性成像与彩色多普勒超声在乳腺占位性病变鉴别诊断中的应用价值。方法选取2012年1月-2015年4月该院收治的乳腺占位性病变手术患者92例(103个病灶)为研究对象,且病灶均通过病理检查确诊,对所有患者的超声弹性成像与彩色多普勒超声表现进行回顾性分析。以手术病理检查结果为对照,对两者的诊断准确率进行比较。结果弹性成像评分≥4分为恶性病变,≤3分为良性病变,以手术病理结果作为对照,弹性成像诊断敏感性为90.9%(50/55),特异性为93.8%(45/48),准确率为92.2%(95/103)。根据Adler血流分级标准,0~I级为良性病变;Ⅱ~Ⅲ级为恶性病变,以手术病理结果作为对照,彩色多普勒超声诊断敏感性为80.0%(44/55),特异性为83.3%(40/48),准确率为81.6%(84/103)。103个病灶中,超声弹性成像技术正确诊断病灶数为95个,准确率为92.2%;彩色多普勒超声正确诊断病灶数为84个,准确率为81.6%,组间比较诊断准确率差异有统计学意义(P<0.05)。结论超声弹性成像技术在乳腺占位病变良恶性的鉴别诊断中的准确性要高于彩色多普勒超声,但会出现一定程度的漏诊及误诊现象,因此在临床应用中应联合彩色多普勒超声,以提高诊断准确率。
Objective To comparatively analyze the value of elastography and color Doppler ultrasonography in the differential diagnosis of breast occupying lesions. Methods Ninety-two patients (103 lesions) undergoing breast lesions surgery from January 2012 to April 2015 in our hospital were enrolled in the study. All the lesions were confirmed by pathology. Ultrasound elastography and color Doppler ultrasound findings were retrospectively analyzed. The results of surgical pathology as a control, the diagnostic accuracy of the two were compared. Results Elastography score≥4 was classified as malignant lesions, ≤3 as benign lesions. The pathological results were used as control. The sensitivity, specificity and accuracy of elastography were 90.9% (50/55) and 93.8% (45/48), respectively. The accuracy rate was 92.2% (95/103). According to Adler’s blood flow grading criteria, grade 0 to grade 1 were benign lesions; grade Ⅱ to Ⅲ were malignant lesions. The pathological results were used as controls. The sensitivity of color Doppler ultrasound was 80.0% (44/55) and the specificity was 83.3% (40/48), the accuracy rate was 81.6% (84/103). Among the 103 lesions, the number of correctly diagnosed lesions was 95 and the accuracy rate was 92.2%. The correct number of lesions was 84 and the accuracy rate was 81.6% by color Doppler ultrasound. There was a significant difference in diagnostic accuracy between groups Statistical significance (P <0.05). Conclusion Ultrasound elastography in the differential diagnosis of benign and malignant breast lesions in the accuracy of the diagnosis of higher than color Doppler ultrasound, but there will be some degree of missed diagnosis and misdiagnosis, so in clinical application should be combined with color Doppler Ultrasound to improve the diagnostic accuracy.