超声积分法对乳腺实性肿块的鉴别诊断价值的研究

目的 探讨超声积分法在乳腺实性肿块良、恶性中的鉴别诊断价值.方法 选择经手术病理证实的125例136个乳腺实性肿块,常规记录全部乳腺肿块的超声征象,并给予赋值评分,计算每个肿块的总积分.根据病变的评分值将其分类,与病理结果对照,采用受试者工作特性曲线(ROC曲线)评价超声积分的诊断价值.结果 由肿块的形态、边界、有无包膜、纵横比例、后方回声、内部回声、有无微钙化及血流显示8项指标综合而成的肿块的总积分有差异,恶性肿块得分高于良性肿块;ROC曲线下的面积Az=0.915,其95%可信区间为(0.863、0.968).总积分13.5分作为临界值,其敏感性、特异性分别为84.9%、88.9%.结论 超声积分法能半定量分析乳腺实性肿块的二维及彩色多普勒超声征象,可以提高超声诊断的准确率.

Evaluation of Ultrasonic Scores in Differentiation Diagnosis of Solid Breast Masses

Objective To investigate the value of differentiation diagnosis of solid breast masses by ultrasonic scores in 2D and CDFI features.Methods 136 solid breast masses of 125 cases had been diagnosed by pathology.All the ultrasonographic features of breast masses were reported routinely by 2D high frequency Ultrasonography(HFU)and the shape,margin,capsule,the ratio of length-to-width,internal echoes,posterior acoustic features,microcalcification and blood flow of solid breast masses were analyzed and graded.The total scores for each lesion were calculated.The masses were classified according to their scores compared with pathology results.A receiver operating characteristic(ROC)curve was used to assess the diagnostic value of ultrasonic scores.Results There were differences between the total scores of malignant and benign lesions.The former was higher than the latter.The area under the ROC curve was 0.915 and its 95% confidence interval was (0.863，0.968).The diagnostic sensitivity and specificity were 84.9% and 88.9% while the cut-off value was 13.5.Conclusions Ultrasonic scores could be used to analyze the features of 2D and CDFI of solid breast masses objectively and semi-quantitatively and increase the diagnostic accuracy of solid breast masses in differentiation between benign and malignant ones.