超声弹性成像诊断乳腺肿块的准确度及其证实偏倚校正的研究

发布时间：2018-03-18 11:18

本文选题：超声弹性　切入点：最大似然估计　出处：《中国超声医学杂志》2015年04期 　论文类型：期刊论文

【摘要】：目的评价超声弹性成像(UE)诊断乳腺肿块的准确度,分析证实偏倚校正后的灵敏度、特异度,以便临床客观而全面地认识UE诊断结果。方法对1 568例患者分别进行常规彩超及UE检查,检查结果与病理结果对照。然后用最大似然估计法对UE诊断乳腺肿块的灵敏度和特异度进行校正。结果超声诊断为恶性的患者接受手术的概率为70.93%,超声诊断为良性的患者接受手术的概率为19.72%,两者间差异具有统计学意义(P0.000 1)。证实偏倚校正前灵敏度95.04%,95%CI(92.51~97.57),校正后的灵敏度为84.19%,95%CI(77.21~91.17),两者95%可信区间无交集,差异有统计学意义;证实偏倚校正前特异度为84.16%,95%CI(80.29~88.03),校正后的特异度为95.03%,95%CI(91.06~99.10),两者95%可信区间无交集,差异具有统计学意义;证实偏倚校正后的特异度高于校正前,校正后的灵敏度低于校正前。结论 UE诊断乳腺癌的准确度较高,但因证实偏倚的存在,影响临床对UE诊断乳腺癌的准确度评价。
[Abstract]:Objective to evaluate the accuracy of ultrasonic elastic imaging (UEE) in the diagnosis of breast masses, and to analyze the sensitivity and specificity of bias correction. Methods 1 568 cases of UE were examined by routine color Doppler ultrasound and UE respectively. The sensitivity and specificity of UE in the diagnosis of breast masses were corrected by maximum likelihood estimation. Results the probability of operation was 70.93% in the patients diagnosed malignant by ultrasound, and the diagnosis was good by ultrasound. The probability of surgery was 19.72.The difference between the two was statistically significant (P < 0.01). The sensitivity before the bias correction was 95.04 and 95CI92.51 / 97.57, and the corrected sensitivity was 84.1995 / 95 / 77.21 / 91.17, respectively. There was no overlap between the two 95% confidence intervals. The difference was statistically significant, the specificity before bias correction was 84.16 / 95 and 80.29 / 88.03, and the specificity after correction was 95.03 / 95CI91.06 / 99.100.The difference between the two 95% confidence intervals was statistically significant, and the specificity after bias correction was higher than that before correction. Conclusion the accuracy of UE in the diagnosis of breast cancer is higher than that before correction.
【作者单位】：郑州大学第二附属医院超声科;郑州大学第一附属医院超声科;
【分类号】：R737.9;R445.1

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