超声弹性评分法对乳腺小肿块的诊断价值

探讨超声弹性成像(ultrasound elastography,UE)评分法对乳腺小肿块的诊断价值。方法选择行乳腺检查的患者99例(102个乳腺肿块,直径≤2cm),将102个直径≤2cm的乳腺肿块按大小分为2组:Ⅰ组(乳腺肿块直径>1～≤2cm组)60个和Ⅱ组(乳腺肿块直径≤1cm组)42个。2组均行常规超声检查后进行弹性成像检查。采用UE评分法(5分评分法)对所有乳腺肿块进行UE评分。根据UE评分法计算直径≤2cm的乳腺肿块和Ⅰ组、Ⅱ组的敏感性、特异性、准确性、阳性预测值、阴性预测值。结果 102个≤2cm的乳腺肿块中,病理诊断为良性53个、恶性49个。UE评分法对直径≤2cm的乳腺肿块诊断的敏感性、特异性、准确性、阳性预测值、阴性预测值分别为83.67%、88.68%、86.27%、87.23%、85.45%。Ⅰ组、Ⅱ组的敏感性、特异性、准确性、阳性预测值、阴性预测值分别为80.00%、86.67%、83.33%、85.71%、81.25%和89.47%、91.30%、90.48%、89.47%、91.30%,Ⅱ组的敏感性、特异性、准确性、阳性预测值、阴性预测值均明显高于Ⅰ组(均P<0.05)。结论 UE评分法对乳腺小肿块具有较高的诊断价值,有助于早期乳腺癌的诊断。

Diagnostic Value of Ultrasound Elastography Scoring in Small Breast Lumps

Objective To explore the diagnostic value of ultrasound elastography(UE) scoring method in small breast lumps.Methods Select 99 patients that accept routine breast examination(102 breast lumps,≤2 cm in diameter). A total of 102 breast lumps were divided into group Ⅰ(breast lumps >1-≤ 2 cm in diameter,n=60) and group Ⅱ(breast lumps ≤1 cm in diameter,n=42).The elastographic examination was performed after routine ultrasound examination in all lumps. Application of UE scoring method(5 points scoring method) to score all the breast lumps.Calculate the sensitivity,specificity,accuracy,positive predictive value and negative predictive value of all the breast lumps ≤2 cm in diameter and group Ⅰ,groupⅡ by UE scoring method. Results Among the 102 breast lumps ≤2 cm,pathological results were benign in 53 and malignant in 49.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of UE scoring method for the diagnosis of breast lumps(≤2 cm in diameter) were 83.67%,88.68%,86.27%,87.23% and 85.45%,respectively.Compared with group Ⅰ,the sensitivity,specificity,accuracy,positive predictive value and negative predictive value of UE scoring method were significantly increased in group Ⅱ(80.00%,86.67%,83.33%,85.71% and 81.25% vs 89.47%,91.30%,90.48%,89.47% and 91.30%,respectively;all P<0.05).Conclusion UE scoring method has a high diagnostic value in small breast lumps and can contribute to the diagnosis of early breast cancer.