灰阶超声图像特征在乳腺肿瘤良恶性鉴别诊断中的价值

目的探讨乳腺灰阶超声图像特征在良恶性肿瘤鉴别诊断中的价值。方法应用超声显像观察乳腺肿瘤6项征象:肿瘤形态、轮廓、包膜、肿瘤内部结构回声、肿瘤内部微小钙化及后方回声衰减,并与乳腺纤维瘤声像图作对照,比较二者的敏感度、特异性及准确率。结果超声对乳腺良性肿瘤的诊断符合率为85.3%(5868),恶性肿瘤的诊断符合率为96.4%(8184)。以肿瘤形态不规则作鉴别,乳腺癌的敏感度为82.95%,特异性为87.69%,准确率为84.90%;以肿瘤轮廓锯齿状毛刺样作鉴别,乳腺癌的敏感度为80.68%,特异性为93.84%,准确率为86.27%;以肿瘤周边无包膜或壁作鉴别,乳腺癌的敏感度为78.40%,特异性为92.30%,准确率为83.00%;以肿瘤内部结构回声不均匀作鉴别,乳腺癌的敏感度为70.45%,特异性为86.15%,准确率为77.12%;以肿瘤内部微小钙化灶作鉴别,敏感度为25.00%,特异性为95.38%,准确率为54.90%;以肿瘤后方回声衰减作鉴别,乳腺癌的敏感度为10.22%,特异性为92.30%,准确率为45.09%。结论以乳腺肿瘤6项超声征象中前4项进行鉴别可获得较满意的诊断效果。

Grey scale ultranographic imaging in the differential diagnosis of benign and malignant breast tumor lesions

Objective To investigate the role of ultrasonographic imaging in differential diagnosis of benign and malignant breast tumor lesions.Methods Six items of the breast tumor, such as tumor shape, tumor outline, tumor tunica, internal structure echo of the tumor, calcifying nodule of the tumor and posterior echo weakness of the tumor, the sensibility,specificity and accuracy were compared to breast fibroma.Results The coincidence rates of the ultrasonography to breast benign tumor were 85.3%(58/68) and the rates of ultrasonography to the breast malignant tumor were 96.4%(81/84). As the differentiation of irregular shape of the tumor, the sensibility of breast carcinoma was 82.95%, the specificity was 87.69%, and the accuracy was 84.96%; as the differentiation of the tumor saw-tooth hairy outline, the sensibility of breast carcinoma was 80.68%, the specificity was 93.84% and the accuracy was 86.27%; as the differentiation for no tunica or wall around the tumor, the sensibility of breast carcinoma was 78.40%, the specificity was 92.30% and the accuracy was 83.00%; as the differentiation of the bad distributed echo for internal structure of the tumor, the sensibility of breast carcinoma was 70.45%, the specificity was 86.15% and the accuracy was 77.12%; as the differentiation for calcifying nodule of tumor, the sensibility of breast carcinoma was 25.00%, the specificity was 95.38% and the accuracy was 54.90%; as the differentiation for yes or no posterior echo weakness of the tumor, the sensibility of breast carcinoma was 10.22%, the specificity was 92.30% and the accuracy was 45.09%.Conclusion Satisfactory diagnosis could be obtained by discriminating the former four items of the ultranographic imaging.