超声造影技术与三维超声成像对乳腺良恶性结节的鉴别诊断价值

目的：探讨超声造影技术（ CEUS）与三维超声成像检查对乳腺良恶性结节的鉴别诊断价值。方法对89例乳腺肿块患者，共计113个病灶分别进行CEUS及三维超声成像检查，分析两种方法的病灶特点，并根据术后病理检查结果进行诊断学效能评价。结果根据术后病理检查结果分为恶性结节51例、良性结节62例，三维超声成像在113个乳腺良恶性结节良恶性鉴别中均具有显著差异（P＜0．05）。 CEUS检查在增强、边缘强化及增强程度方面对良恶性鉴别均具有显著差异（P＜0．05）；在消退模式方面CEUS鉴别良恶性差异不显著（P＞0．05）。三维超声成像检查鉴别结节的灵敏度，特异度、阳性预测值、阴性预测值，与病理学检查结果的一致性Kappa值均高于CEUS；两者联合检查的灵敏度为96．08％、特异度为95．16％、漏诊率为4．84％、误诊率为3．92％、阳性预测值为94．23％、阴性预测值为96．72％、Kap-pa为0．911。结论对乳腺良恶性结节鉴别诊断，单独应用三维超声成像的诊断效能与单独使用CEUS检查相当，将两者联合应用能够显著提高术前诊断与术后病理诊断的一致性。

Diagnostic Value of Ultrasound(CEUS) Imaging Technology and Three Dimensional Ultrasound Imaging in the Differential Diagnosis of Benign and Malignant Nodules

Objective To study iagnostic value of Ultrasound ( CEUS) imaging technology and three dimensional ultra-sound imaging in the differential diagnosis of benign and malignant nodules .Methods 89 cases of patients with breast lumps with 113 lesions received CEUS and three dimensional ultrasound imaging ,the characteristics of the lesions of the 2 methods were analyzed,according to the result of postoperative pathologic examination conducted diagnosis efficiency evaluation .Results Ac-cording to the results of the pathological examination ,there had 51 cases of malignant nodules ,benign nodules 62 cases,three di-mensional ultrasound imaging in the differential diagnosis of 113 benign and malignant breast nodules had significant differences (P<0.05).CEUS examination of breast benign and malignant nodules in enhanced mode ,edge enhancement mode,and enhance level had significant differences (P<0.05);in the regression model CEUS differentiating benign and malignant difference was not significant(P>0.05).Three dimensional ultrasound imaging in identification of benign and malignant breast nodules sensitivity , specificity,positive predictive value,negative predictive value,and consistency,the Kappa pathology results were higher than CEUS;both joint inspection sensitivity was 96.08%,specificity degree was 95.16%,misdiagnosis rate was 4.84%misdiagnosis rate was 3.92%,positive predictive value was 94.23%,negative predictive value was 96.72%,Kappa was 0.911.Conclusion In the differential diagnosis of benign and malignant breast nodules ,three dimensional ultrasound imaging and CEUS examination have similar results ,their combination can significantly improve the consistency of diagnosis before surgery and postoperative path -ological diagnosis .