摘要
目的探讨超声弹性应变率比值法(SR)在乳腺良恶性肿瘤诊断中的最佳诊断界点及其对乳腺肿块的诊断价值。方法对119例乳腺肿块患者共125个病灶进行二维超声及超声弹性成像检查,获得满意弹性图像后,测量病灶组织与周围同水平乳腺组织的SR,并与术后病理对照,以病理结果为金标准,构建ROC曲线,获得弹性SR值鉴别良恶性肿块的最佳诊断界点。结果良、恶性乳腺肿块SR分别为(2.66±0.78)和(4.97±1.93),两者差异有统计学意义(P<0.01)。构建ROC曲线后,曲线下面积(AUC)为0.917,确定的SR最佳诊断界点为3.19,以SR≥3.19判断病灶为恶性,<3.19判定为良性,则SR诊断乳腺恶性病变的敏感性、特异性、准确性、阳性预测值、阴性预测值分别为91.5%、89.4%、90.4%、88.5%、92.2%。结论 SR可以更为客观地评价乳腺肿块的硬度,对乳腺肿块良恶性鉴别具有较高的临床应用价值。
Objective To evaluate the clinical value of strain ratio by ultrasonography in differential diagnosis of breast lesions and the cut-off point of strain ratio for breast lesions. Methods One hundred and twenty-five breast lesions of 119 patients underwent two-dinensional ultrasound （2D-US） and ultrasonic elastography（UE）, to got the relative stiffness of lesion by measuring the strain ratio of breast lesion to the same level breast tissue under good strain images. By comparing with the results of pathological diagnosis and with it as the gold standard,the cut-off point for the strain ratio was got using the receiver operating characteristic curve. Results The strain ratio of the benign lesions was（2.66±0.78）, which was different from that of malignant ones （4.97±1.93）（P〈0.05）.The area under the curve was 0.917 and it determined the cut-off point for strain ratio was 3.19.If the strain ratio〉3.19 for malignancy and 〈3.19 for benignity, the sensitivity, specificity, accuracy, positive predictive value and negative predictive value were 89.4%, 86.8%, 88.5%, 93.0% and 80.7%, respectively in identifying malignant breast tumors. Conclusion Strain ratio can reflect the stiffness of breast lesions more objectively, and represent a high clinical value for differentiation of benign and malignant breast tumors.
出处
《当代医学》
2012年第1期7-9,共3页
Contemporary Medicine
