弹性应变率比值与BI-RADS标准鉴别诊断乳腺肿块的对比研究

目的：探讨弹性应变率比值( SR)诊断乳腺良恶性肿块的最佳界点,对比分析SR与常规超声乳腺影像报告和数据系统( BI-RADS)标准对乳腺肿块的鉴别诊断价值。方法对94例患者共计101个乳腺肿块进行 SR 测定和 BI-RADS标准分级,以病理结果为标准,构建SR的受试者工作特征( ROC)曲线,确定其诊断乳腺肿块良恶性的最佳界点,并比较SR与BI-RADS标准的诊断价值。结果 SR的ROC曲线下面积(AUC)为0．933,最佳诊断界点为3．03,以SR≥3．03诊断为恶性, SR <3．03诊断为良性；良性组 SR 为(1．96±0．88),恶性组SR为(4．74±2．22),两组比较差异有统计学意义( P<0．01)。 SR和BI-RADS标准诊断乳腺肿块的敏感度、特异度、准确度、阳性预测值、阴性预测值分别为92．3%、88．7%、90．1%、83．7%、94．8%及71．8%、87．1%、81．2%、77．8%、83．1%, SR 的诊断敏感度高于 BI-RADS标准( P<0．05)。结论作为一种半定量检查方法, SR比BI-RADS标准具有更高的敏感度,可以提高乳腺恶性肿块的检出率。

Comparative study of elastic strain ratio and BI-RADS standard in differential diagnosis of breast lesions

Objective To investigate the optimal points of elastic strain ratio ( SR) in diagnosis of benign and ma-lignant breast lesions and compare the diagnostic value of SR with BI-RADS standard. Methods 94 patients with 101 breast lesions were included in the study. The lesions were scored with BI-RADS standard and SR respective-ly. The pathologic diagnosis was the gold standard. Constructed the receiver operating characteristic ( ROC) curve and determined the optimal points of SR in the diagnosis of malignant breast lesions. Compared the diagnostic value of SR with BI-RADS standard. Results The area under the curve of SR was 0. 933,the cut-off point for strain ratio was 3. 03. The strain ratio of benign group was (1. 96 ± 0. 88),the malignant group was (4. 74 ± 2. 22),there was significant difference between two groups(P<0. 01). The sensitivity,specificity,accuracy,positive predictive value , negative predictive value of strain ratio and Conventional ultrasound were 92. 3%,88. 7%,90. 1%,83. 7%, 94. 8% and 71. 8%,87. 1%,81. 2%,77. 8%,83. 1%. Sensitivity of strain ratio was better than BI-RADS standard (P<0. 05). Conclusion As a semi quantitative method,SR is more sensitive than BI-RADS standard. It can im-prove the detection rate of malignant breast lesions.