摘要
目的探究二维超声BI-RADS分类联合最大弹性模量值(SWEmax)和阻力指数(RI)在乳腺良恶性结节中的诊断效能。方法回顾性分析2017年2月至2021年5月广东省第二中医院收治的191例乳腺结节患者,按照手术病理结果,分为良性组(55例)和恶性组(136例),分析乳腺结节的二维超声征象,将乳腺结节进行BI-RADS分类,采用ROC曲线分析二维超声BI-RADS分类、超声BI-RADS分类分别联合SWEmax、RI对乳腺恶性结节的诊断价值,比较二维超声BI-RADS分类、超声BI-RADS分类分别与SWEmax、RI联合诊断乳腺恶性结节的灵敏度、特异度、准确率和误诊率。结果经ROC曲线分析,超声BI-RADS分类与SWEmax或RI联合诊断乳腺恶性结节的AUC均大于二维超声BI-RADS分类单独诊断(P<0.05)。以病理结果为金标准,以SWEmax=70.5 Kpa,RI=0.70为临界值,超声BI-RADS分类与SWEmax或RI联合诊断乳腺恶性结节的特异度、准确率均大于二维超声BI-RADS分类单独诊断(P<0.05),而联合诊断的误诊率均小于二维超声BI-RADS分类单独诊断(P<0.05);二维超声BI-RADS分类、BI-RADS分类联合SWEmax、BI-RADS分类联合RI诊断的灵敏度差异均无统计学意义(P>0.05)。结论二维超声BI-RADS分类与SWEmax或RI联合诊断乳腺恶性结节的AUC、特异度、准确率均比二维超声BI-RADS分类单独诊断高,误诊率降低,可以明显提高乳腺结节的诊断效能,值得临床推广应用。
Objective To investigate the diagnostic efficacy of two-dimensional(2D)ultrasound breast imaging reporting and data system(BI-RADS)classification combined with maximum elastic modulus value obtained by shear wave elastography(SWEmax)and resistance index(RI)in the diagnosis of benign and malignant breast nodules.Methods A total of 191 patients with breast nodules admitted to Guangdong Second Traditional Chinese Medical Hospital from February 2017 to May 2021 were retrospectively analyzed.They were divided into the benign group(n=55)and the malignant group(n=136)according to surgical and pathological findings.The 2D ultrasound signs of breast nodules were analyzed,and the breast nodules were classified by BI-RADS.The values of 2D ultrasound BI-RADS classification and ultrasound BI-RADS classification combined with SWEmax and RI in the diagnosis of malignant breast nodules were analyzed respectively using receiver operating characteristic(ROC)curve,and the sensitivity,specificity,accuracy and misdiagnosis rates of 2D ultrasound BI-RADS classification and ultrasound BI-RADS classification combined with SWEmax and RI in the diagnosis of malignant breast nodules were compared.Results According to the ROC curve analysis,it was found that the area under the curve(AUC)of the combined diagnosis of breast malignant nodules by ultrasound BI-RADS classification with SWEmax or RI was greater than that by 2D ultrasound BI-RADS classification alone(P<0.05).Taking pathological findings as the gold standard and SWEmax=70.5 Kpa and RI=0.70 as the critical values,the specificity and accuracy of the combined diagnosis of breast malignant nodules by ultrasound BI-RADS classification with SWEmax or RI were greater than those by 2D ultrasound BI-RADS classification alone(P<0.05),while the misdiagnosis rate of the combined diagnosis by ultrasound BI-RADS classification with SWEmax or RI was less than that by 2D ultrasound BI-RADS classification alone(P<0.05).There were no statistically significant differences in the diagnostic sensitivit
作者
陈艳铨
李佳
邓敏君
CHEN Yanquan;LI Jia;DENG Minjun(Department of Medical Technology,Guangdong Second Traditional Chinese Medical Hospital,Guangdong,Guangzhou 510095,China)
出处
《中国医药科学》
2022年第5期160-164,共5页
China Medicine And Pharmacy
关键词
最大弹性模量值
阻力指数
二维超声BI-RADS分类
诊断效能
Maximum elastic modulus value
Resistance index
Two-dimensional ultrasound BI-RADS classification
Diagnostic efficacy
