目的探讨弹性定量参数应变率(SR)比值、直径变化率及面积比对临床触诊阴性乳腺病灶(non-palpable breast lesions,NPBL)的诊断价值。方法选取150例经超声检查和手术病理证实的NPBL患者,根据术后病理结果分为良性病灶组(A组,n=110)和恶...目的探讨弹性定量参数应变率(SR)比值、直径变化率及面积比对临床触诊阴性乳腺病灶(non-palpable breast lesions,NPBL)的诊断价值。方法选取150例经超声检查和手术病理证实的NPBL患者,根据术后病理结果分为良性病灶组(A组,n=110)和恶性病灶组(B组,n=40),比较两组SR比值、直径变化率及面积比。应用ROC曲线分析SR比值、直径变化率、面积比及其联合诊断乳腺恶性病灶的ROC曲线下面积、临界值、敏感性及特异性,并对其进行比较。结果 B组SR比值(6.04±2.53)显著高于A组(2.86±1.51),差异有统计学意义(t=5.031,P=0.000),常规超声与弹性成像测得A组病灶的直径和面积差异均无统计学意义,而弹性成像测得B组病灶的直径与面积均显著高于常规超声测值,差异均有统计学意义(P=0.000、0.016)。B组病灶的直径变化率显著高于A组(P=0.000),面积比亦显著高于A组(P=0.025)。应用SR比值、直径变化率及面积比联合诊断乳腺恶性病灶的敏感性为77.5%,特异性为94.5%,曲线下面积为0.937,高于SR比值、直径变化率及面积比单独诊断的效能。结论弹性定量参数SR比值、直径变化率及面积比在NPBL良恶性鉴别中均有效,而其联合诊断能够显著提高对乳腺病灶良恶性的鉴别能力。展开更多
目的：探讨钼靶 X 线引导下导丝定位用于切除乳腺亚临床病灶的应用效果。方法收集2011年1月至2013年1月滨州医学院附属医院收治的经临床检查未触及明显乳腺肿块但钼靶摄片表现异常的患者80例，应用钼靶 X 线引导下导丝定位实施切除手术...目的：探讨钼靶 X 线引导下导丝定位用于切除乳腺亚临床病灶的应用效果。方法收集2011年1月至2013年1月滨州医学院附属医院收治的经临床检查未触及明显乳腺肿块但钼靶摄片表现异常的患者80例，应用钼靶 X 线引导下导丝定位实施切除手术，术后行病理学检查。结果本研究80例患者的病灶均定位准确，病变组织均完全切除，总成功率为100%。其中乳腺癌9例，乳腺纤维瘤4例，乳腺炎症2例，乳腺不典型增生5例，导管内乳头状瘤2例，乳腺增生合并钙化58例，脂肪坏死3例。结论采用钼靶 X 线引导下导丝定位可准确定位乳腺亚临床病灶，有利于早期准确诊断不可触及的乳腺病变，提高临床手术切除效果，值得推广应用。展开更多
A blinded retrospective validation study was performed in a university-based hospital in northeastern China to determine whether the breast imaging reporting and data system (BI- RADS) defines a group of patients with...A blinded retrospective validation study was performed in a university-based hospital in northeastern China to determine whether the breast imaging reporting and data system (BI- RADS) defines a group of patients with non- palpable breast lesions (NPBLs) in whom fine- wire localization biopsy (FWLB) is appropriate. We reviewed 182 consecutive patients with NPBLs who underwent FWLB. The patients’ preoperative mammograms were categorized according BI-RADS by 2 radiologists blinded to the pathological findings. The positive predictive values of BI-RADS categories 3-5 were 3.4%, 42.1%, and 76.9%, respectively. For category 4 NPBLs, the percentage of cancer for those aged < 40 years was significantly lower than those aged ≥ 40 years. For category 3 NPBLs, the percentage of precancerous lesions for those aged < 40 years was significantly lower than those aged ≥ 40 years. Chinese NPBL patients aged ≥ 40 years with category 4 mammographic findings, and all patients with category 5 findings should undergo FWLB. FWLB should be offered as a treatment option for Chinese NPBL patients aged < 40 years with category 4 findings or aged ≥ 40 years with category 3 findings.展开更多
文摘目的探讨弹性定量参数应变率(SR)比值、直径变化率及面积比对临床触诊阴性乳腺病灶(non-palpable breast lesions,NPBL)的诊断价值。方法选取150例经超声检查和手术病理证实的NPBL患者,根据术后病理结果分为良性病灶组(A组,n=110)和恶性病灶组(B组,n=40),比较两组SR比值、直径变化率及面积比。应用ROC曲线分析SR比值、直径变化率、面积比及其联合诊断乳腺恶性病灶的ROC曲线下面积、临界值、敏感性及特异性,并对其进行比较。结果 B组SR比值(6.04±2.53)显著高于A组(2.86±1.51),差异有统计学意义(t=5.031,P=0.000),常规超声与弹性成像测得A组病灶的直径和面积差异均无统计学意义,而弹性成像测得B组病灶的直径与面积均显著高于常规超声测值,差异均有统计学意义(P=0.000、0.016)。B组病灶的直径变化率显著高于A组(P=0.000),面积比亦显著高于A组(P=0.025)。应用SR比值、直径变化率及面积比联合诊断乳腺恶性病灶的敏感性为77.5%,特异性为94.5%,曲线下面积为0.937,高于SR比值、直径变化率及面积比单独诊断的效能。结论弹性定量参数SR比值、直径变化率及面积比在NPBL良恶性鉴别中均有效,而其联合诊断能够显著提高对乳腺病灶良恶性的鉴别能力。
文摘目的：探讨钼靶 X 线引导下导丝定位用于切除乳腺亚临床病灶的应用效果。方法收集2011年1月至2013年1月滨州医学院附属医院收治的经临床检查未触及明显乳腺肿块但钼靶摄片表现异常的患者80例，应用钼靶 X 线引导下导丝定位实施切除手术，术后行病理学检查。结果本研究80例患者的病灶均定位准确，病变组织均完全切除，总成功率为100%。其中乳腺癌9例，乳腺纤维瘤4例，乳腺炎症2例，乳腺不典型增生5例，导管内乳头状瘤2例，乳腺增生合并钙化58例，脂肪坏死3例。结论采用钼靶 X 线引导下导丝定位可准确定位乳腺亚临床病灶，有利于早期准确诊断不可触及的乳腺病变，提高临床手术切除效果，值得推广应用。
文摘A blinded retrospective validation study was performed in a university-based hospital in northeastern China to determine whether the breast imaging reporting and data system (BI- RADS) defines a group of patients with non- palpable breast lesions (NPBLs) in whom fine- wire localization biopsy (FWLB) is appropriate. We reviewed 182 consecutive patients with NPBLs who underwent FWLB. The patients’ preoperative mammograms were categorized according BI-RADS by 2 radiologists blinded to the pathological findings. The positive predictive values of BI-RADS categories 3-5 were 3.4%, 42.1%, and 76.9%, respectively. For category 4 NPBLs, the percentage of cancer for those aged < 40 years was significantly lower than those aged ≥ 40 years. For category 3 NPBLs, the percentage of precancerous lesions for those aged < 40 years was significantly lower than those aged ≥ 40 years. Chinese NPBL patients aged ≥ 40 years with category 4 mammographic findings, and all patients with category 5 findings should undergo FWLB. FWLB should be offered as a treatment option for Chinese NPBL patients aged < 40 years with category 4 findings or aged ≥ 40 years with category 3 findings.
