摘要
目的观察彩色多普勒超声及超声电子触诊法鉴别诊断乳腺良恶性病变的临床价值。方法回顾性分析131例乳腺病变患者的临床资料,以病理学结果为金标准,观察彩色多普勒超声及超声弹性成像诊断的准确率、特异度及灵敏度;对统计数据进行分析和Kappa一致性检验,Kappa<0,表示诊断结果一致性差,无实际应用价值;Kappa>0,表示有一定的实际意义;0<Kappa<0.4,表示一致性欠佳;Kappa≥0.75,表示一致性好。结果病理结果显示,131例患者,共检出150个病灶,病灶直径7.1~43.2 mm;良性病变85例,共检出97个病灶,其中乳房纤维腺瘤61个,乳腺炎性病变15个,乳腺增生13个,导管内乳头状瘤3个,纤维脂肪瘤2个,导管扩张2个,不典型增生1个;恶性病变46例,共检出53个病灶,其中浸润性导管癌39个,导管内癌5个,小叶原位癌3个,浸润性小叶癌3个,髓样癌2个,粘液腺癌1个。彩色多普勒超声诊断的准确率为79.4%,灵敏度为78.3%,特异度为80.0%,Kappa=0.563。超声弹性成像诊断的准确率为88.5%,灵敏度为87.0%,特异度为89.4%,Kappa=0.752。结论超声电子触诊法在乳腺良恶性疾病的鉴别诊断方面优于彩色多普勒超声。
Objective To evaluate the clinical value of color Doppler ultrasound and ultrasonic elastography in the differential diagnosis of benign and malignant breast diseases. Methods The clinical data of 131 cases of breast lesion were analyzed retrospectively. Accuracy, specificity and sensitivity of were calculated for color Doppler ultrasound and ultrasonic elastography, considering the pathological diagnosis as the gold standard. Kappa consistency test was performed to measure the inter-rater reliability. Kappa over 0.75 as excellent,0.40 to 0.75 as fair to good and below 0.40 as poor. Results Pathological results showed that there were 150 niduses with the diameter of 7.1 -43.2 mm among 131 patients. There were 85 cases of benign lesion with 97 niduses, including 6t niduses in breast fibroadenoma, 15 niduses in mammary gland inflammatory lesion, 13 niduses in mammary gland hyperplasia,3 niduses in intraductal papilloma,2 niduses in fibrolipoma,2 niduses in duct eetasia, 1 nidus in atypical hyperplasia. There were 46 cases of malignant lesion with 53 niduses, including 39 niduses in invasive ductal carcinoma,5 niduses in intraductal carcinoma,3 niduses in lobular carcinoma in situ ,3 niduses in invasive lobular carcinoma,2 niduses in medullary carcinoma, and 1 nidus in mutinous adenocarcinoma. The accuracy, sensitivity and specificity for color Doppler ultrasound was 79.4% ,78.3% and 80.0%, respectively, Kappa= 0. 563; while the accuracy, sensitivity and specificity for ultrasonic elastography was 88. 5%, 87. 0% and 89.4%, respectively,Kappa = 0.752. Conclusion The ultrasonic elastography have advantages over color Doppler ultrasound in the differential diagnosis of benign and malignant breast diseases.
出处
《中华全科医学》
2017年第7期1213-1216,共4页
Chinese Journal of General Practice
关键词
乳腺
彩色多普勒超声
超声弹性成像
Breast lesions
Color Doppler ultrasound
Ultrasonic elastography
