超声弹性成像应变率比值法和改良5分法对乳腺病灶良恶性诊断价值的比较

发布时间：2018-11-28 19:14

【摘要】：目的：探讨并比较超声弹性成像应变率比值法与改良5分法对乳腺病灶良恶性鉴别诊断的价值。材料与方法：对130名女性乳腺病灶患者，行超声弹性成像（UE）检查，待弹性图像稳定后，获得乳腺病灶UE图像，先分析病灶区颜色分布，应用改良5分法对病灶进行评分（评分细则详见正文表1）；再测量出乳腺病灶的应变率比值（strain ratio，SR），每个病灶重复2～3次，取其平均值。所有病例均经病理证实，将两种方法所得结果与病理结果相对照，描绘受试者工作特征（ROC）曲线，获得乳腺良恶性病灶SR的最佳诊断界值，比较两种方法对乳腺病灶良恶性诊断的效能。结果：（1）130名患者共155个乳腺病灶，其中良性120个，，恶性35个。乳腺恶性组SR值明显高于良性病灶组SR值（3.93±1.06vs.1.82±0.83），两者差异具有统计学意义（t=-4.339，P＜0.05）。（2）通过构建ROC曲线分析，乳腺良恶性病灶SR的最佳诊断界值为3.05，其诊断乳腺恶性病灶的敏感性、特异性、准确性、阳性预测值和阴性预测值分别为85.7%（30/35）、94.1%（113/120）、92.2%（143/155）、81.0%（30/37）和95.8%（113/118）。而改良5分法诊断乳腺恶性病灶的敏感性、特异性、准确性、阳性预测值和阴性预测值分别为80.0%（28/35）、93.3%（112/120）、90.3%（140/155）、77.8%（28/36）和94.1%（112/119）。（3）SR值诊断乳腺恶性病灶的ROC曲线下面积为0.93，改良5分法诊断乳腺恶性病灶的ROC曲线下面积为0.89，两者差异无统计学意义（Z=0.88，P＞0.05）。（4）弹性应变率比值法与改良5分法诊断乳腺恶性病灶的敏感性、特异性、准确性、阳性预测值和阴性预测值之间差异均无统计学意义（P均＞0.05）。结论：乳腺恶性病灶SR值高于良性病灶，SR诊断界值3.05对乳腺良恶性病灶鉴别诊断有较高的诊断效能。弹性应变率比值法与改良5分法对乳腺病灶良恶性的诊断均具有较高价值，两种方法诊断效能相近。弹性应变率比值法可获得半定量指标，临床更具实用性。
[Abstract]:Objective: to study and compare the value of strain rate ratio method and modified 5 score method in differential diagnosis of benign and malignant breast lesions. Materials and methods: a total of 130 female patients with breast lesions were examined by (UE). After the elastic images were stabilized, the UE images of the lesions were obtained, and the color distribution of the lesions was analyzed first. The lesion was graded by the modified 5-score method (detailed scoring details are shown in Table 1 of the text); The strain rate ratio (strain ratio,SR) of breast lesions was measured. All the cases were confirmed by pathology. The results obtained by two methods were compared with the pathological results, and the (ROC) curves of the subjects' operating characteristics were described to obtain the best diagnostic limit of SR for benign and malignant breast lesions. To compare the effectiveness of the two methods in the diagnosis of benign and malignant breast lesions. Results: (1) there were 155 breast lesions in 130 patients, of which 120 were benign and 35 malignant. The SR value of breast malignant group was significantly higher than that of benign lesion group (3.93 卤1.06vs.1.82 卤0.83). The difference between the two groups was statistically significant (t = -4.339, P < 0. 05). (2). The best diagnostic threshold of SR for benign and malignant breast lesions was 3.05. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of SR were 85.7% (30 / 35) and 94.1% (113 / 120), respectively. 92.2% (143 / 155), 81.0% (30 / 37) and 95.8% (113 / 118). The sensitivity, specificity, accuracy, positive predictive value and negative predictive value were 80.0% (28 / 35), 90.3% (112 / 120), 90.3% (140 / 155), respectively. The area under ROC curve of 77.8% (28 / 36) and 94.1% (112 / 119). (3) of breast malignant lesions was 0.93, and the area under ROC curve of modified 5-score method was 0.89. There was no significant difference between the two methods (P > 0. 05). (4). The sensitivity, specificity and accuracy of the elastic strain rate ratio method and the modified 5 score method in the diagnosis of breast malignant lesions were not significant (P > 0. 05). (4). There was no significant difference between positive predictive value and negative predictive value (P > 0.05). Conclusion: the SR value of malignant breast lesions is higher than that of benign lesions. The diagnostic threshold value of SR is higher than that of benign and malignant breast lesions. Both the elastic strain rate ratio method and the modified five score method are of high value in the diagnosis of benign and malignant breast lesions, and the two methods have similar diagnostic efficacy. The elastic strain rate ratio method can obtain the semi-quantitative index, which is more practical in clinic.
【学位授予单位】：苏州大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R445.1;R737.9

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