摘要
目的比较高频超声联合弹性应变率比值与磁共振成像(MRI)诊断乳腺癌的临床应用价值。方法回顾性选取2016年5月至2017年4月因乳腺肿块在中国人民解放军联勤保障部队第九〇四医院甲乳外科就诊的65例患者,共84个病灶。所有病灶均经穿刺或手术取得病理结果。所有患者穿刺或手术前均行高频超声及弹性成像检查,且行增强MRI扫描。以病理结果为"金标准",绘制ROC曲线,得出高频超声联合弹性应变率比值诊断乳腺癌的敏感度、特异度、准确性,利用四格表计算MRI诊断乳腺癌的敏感度、特异度、准确性,对二者的诊断效能进行分析比较。结果病理结果显示,84个病灶中,良性肿块47个,乳腺癌病灶37个。高频超声结合弹性应变率比值诊断乳腺癌的ROC曲线下面积为0.892,弹性应变率比值最佳截断值为3.01,诊断敏感度、特异度、准确性分别为91.9%、89.4%、90.5%。MRI诊断乳腺癌的敏感度、特异度、准确性分别为94.6%、89.4%、91.7%。高频超声联合弹性应变率比值与MRI诊断效能均较高,差异无统计学意义(P均>0.05)。结论弹性应变率比值是反映乳腺肿块硬度的重要指标,结合高频超声对乳腺癌具有良好的诊断效能;与MRI相比,其具有便捷、高效、费用低等优点,更适用于乳腺癌的早期筛查。
Objective To compare the clinical application value of high frequency ultrasound combined with elastography strain rate ratio(SRR)versus magnetic resonance imaging(MRI)in the diagnosis of breast cancer.Methods A retrospective analysis was performed on 65 patients with 84 breast lesions at The 904th Hospital of the PLA Joint Service Support from May 2016 to April 2017.Pathological results were obtained through puncture or surgery for all lesions.High frequency ultrasound and elastography were performed in all patients before puncture or operation,and enhanced MRI scanning was performed.ROC analysis was performed with pathological results as the"gold standard"to calculate the sensitivity,specificity,and accuracy of high frequency ultrasound combined with elastic SRR in the diagnosis of breast cancer.The sensitivity,specificity,and accuracy of MRI for diagnosis of breast cancer were also calculated using the four-fold table.Results The pathological results showed 47 benign masses and 37 breast cancer lesions.The area under ROC curve of high frequency ultrasound combined with SRR was 0.892.With an SRR threshold of 3.01,the accuracy,sensitivity,and specificity of SRR for diagnosis of breast cancer were 91.9%,89.4%,and 90.5%,respectively.The sensitivity,specificity,and accuracy of MRI in the diagnosis of breast cancer were 94.6%,89.4%,and 91.7%,respectively.The sensitivity,specificity,and accuracy of high frequency ultrasound combined with elastic SRR and MRI in the diagnosis of breast cancer were both high,and there was no significant difference between them(P>0.05).Conclusion The elastic SRR is an important index to reflect the hardness of breast lesions.Combining two-dimensional ultrasound and color Doppler blood flow characteristics has good diagnostic efficacy for breast cancer.Compared with MRI,high frequency ultrasound combined with SRR has the advantages of quickness,high efficiency,and low cost,and is more suitable for early screening of breast neoplasms.
作者
施海建
丁洁
姥义
Shi Haijian;Ding Jie;Mu Yi(Department of Ultrasound,the 904th Hospital of the PLA Joint Service Support Force,Wuxi 214044,China;Department of Ultrasound,Wuxi Maternal and Child Health-Care Hospital Affiliated to Nanjing Medical University,Wuxi 214000,China)
出处
《中华医学超声杂志（电子版）》
CSCD
北大核心
2020年第10期993-998,共6页
Chinese Journal of Medical Ultrasound(Electronic Edition)
关键词
乳腺肿瘤
超声检查
弹性成像
磁共振成像
Breast neoplasms
Ultrasonography
Ultrasonic elastography
Magnetic resonance imaging
