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目的对比超声结合弹性成像与常规超声、超声弹性成像评分(UE)的诊断差异,寻找更灵敏的鉴别非哺乳期乳腺良恶性病变的检测方法。方法选择接受治疗的264例非哺乳期患者(312个乳腺病灶,恶性97个,良性215个)进行常规超声和UE检测,检测结果与组织病理学检测结果比较,对比三种方法的准确度、灵敏度以及特异度。结果超声诊断检测结果良性病灶166个,检测正确149个,恶性病灶146个,检测正确80个,准确度、灵敏度、特异度、阳性预测值和阴性预测值分别为73.39%、82.47%、69.30%、54.79%、89.76%;超声弹性成像评分结果为≤3分(良性)189个,检测正确176个,≥4分(恶性)123个,检测正确83个,准确度、灵敏度、特异度、阳性预测值和阴性预测值分别为83.01%、83.51%、81.86%、65.85%、93.12%;超声结合弹性成像结果为良性病灶207个,检测正确197个,恶性病灶105个,检测正确90个,准确度、灵敏度、特异度、阳性预测值和阴性预测值分别为93.35%、92.78%、91.63%、85.71%、95.17%。三组准确度、特异度比较差异有统计学意义(P<0.05),常规超声与弹性成像的灵敏度、阳性预测值和阴性预测值比较差异未见统计学意义(P<0.05),而与超声合并弹性成像组比较差异有统计学意义(P<0.05)。结论超声结合弹性成像在诊断非哺乳期乳腺良恶性病变时,灵敏度高,特异度好,具有重要临床检测价值,值得推广。
OBJECTIVE: To compare the diagnostic differences between ultrasound-combined elastography and routine ultrasound and elastography (UE) to find a more sensitive method for detecting benign and malignant lesions in non-lactating breast. Methods A total of 264 non-lactating patients (312 breast lesions, 97 malignant and 215 benign) undergoing therapy were selected for routine ultrasound and UE testing. The results were compared with histopathological results. The accuracy of the three methods was compared. Sensitivity and specificity. Results There were 166 benign lesions, 149 correctly detected, 146 malignant lesions and 80 correctly detected. The accuracy, sensitivity, specificity, positive predictive value and negative predictive value were 73.39%, 82.47%, 69.30% , 54.79% and 89.76% respectively. The results of echocardiography were 189 with ≤3 points (benign), 176 correctly detected, ≥4 points (malignant), and 83 correctly detected. The accuracy, sensitivity, specificity and positive The predictive value and negative predictive value were 83.01%, 83.51%, 81.86%, 65.85% and 93.12%, respectively. The number of benign and malignant lesions was 207 correctly detected by ultrasound and elastography, and the number of malignant lesions was 105 The sensitivity, specificity, positive predictive value and negative predictive value were 93.35%, 92.78%, 91.63%, 85.71%, 95.17% respectively. There were significant differences between the three groups in accuracy and specificity (P <0.05). The sensitivity, positive predictive value and negative predictive value of conventional ultrasound and elastography had no statistical significance (P <0.05) The difference between the combined elastography group was statistically significant (P <0.05). Conclusion Ultrasound combined with elastography in the diagnosis of non-lactating breast benign and malignant lesions, high sensitivity and good specificity, has important clinical value, it is worth promoting.