超声弹性成像应变率比值对乳腺实性小肿物BIRADS分类的影响.docVIP

PAGE  PAGE 8 超声弹性成像应变率比值对乳腺实性小肿物BIRADS分类的影响 　　【摘要】目的探讨超声弹性成像应变率比值（SR）对乳腺实性小肿物（≤20 mm）BIRADS分类的诊断价值。方法对58个乳腺实性小肿物进行超声BIRADS分类和SR测定，并结合SR对常规BIRADS分类情况重新进行分类，将上述诊断与病理结果进行比较，构建ROC曲线，比较BIRADS分类和结合SR的BIRADS分类对乳腺肿物恶性风险评估能力。结果常规BIRADS分类与结合SR的BIRADS分类诊断乳腺实性小肿物的灵敏度、特异度、准确性分别是73.68%、71.79%、72.41%与89.47%、89.74%、89.66%。结合SR的BIRADS分类诊断乳腺病变的ROC曲线下面积为0.881，明显高于BIRADS分类的0.757（Z=2.650，P0.01）。结论结合SR的BIRADS分类能明显提高对乳腺实性小肿物诊断的准确性，并能提高对4类乳腺实性小肿物的诊断特异度，有效减少不必要的术前活检。 　　【关键词】超声检查；弹性成像技术；乳腺疾病；BIRADS分类；应变率比值 　　中图分类号：R737.9；R445.1文献标识码：ADOI：10.3969/j.issn2016.03.009 　　【Abstract】ObjectiveTo explore the diagnostic value of ultrasound elastography strain ratio（SR） on the classification of small breast mass BIRADS （≤20 mm）.MethodsConventional ultrasound BIRADS was used to classify 58 small breast mass and measure SR of those neoplasm， then reclassifying the conventional classification of those 58 small breast mass with the combination of SR. The abovementioned ultrasound diagnosis and pathology results were compared， and ROC curve was built. Then， risk assessment ability of BIRADS classification and combination of SR and BIRADS classification for malignant breast neoplasm were compared.ResultsThe sensitivity， specificity and the accuracy rate of the BIRADS were 7368%，71.79%，72.41% respectively， and those of the BIRADS combined with SR were 89.47%，89.74% and 89.66% respectively in the diagnosis of breast cancer. The area under ROC curve of the BIRADS classification combined with SR in the diagnosis of breast lesions was 0.881， which was significantly higher than that（0.757） of the BIRADS classification（Z=2650，P0.01）.ConclusionCombination of SR and BIRADS can significantly improve the diagnostic accuracy of the small breast neoplasm and diagnosis of specific degrees of four kinds of small breast mass， and effectively reduce unnecessary preoperative biopsy. 　　【Key words】ultrasonography；elasticity imaging technique；breast diseases；BIRADS classification；SR 　　超声技术的普及和不断发展使其在乳腺癌筛查中