目的分析常规超声、钼靶X线摄影、超声弹性成像和常规超声+超声弹性成像对触诊阴性乳腺病灶的诊断价值,以提高早期乳腺癌的检出率。方法对触诊阴性乳腺病灶的238例患者(266个肿块,其中恶性79个肿块、良性187个肿块)的术前常规超声、钼靶X线摄影、超声弹性成像和超声+超声弹性成像的诊断结果进行分析,并与术后病理结果作对照。结果钼靶X线摄影的敏感性、特异性和准确性分别为79.8%、75.9%和77.1%;常规超声的敏感性、特异性和准确性分别为77.2%、86.1%和83.5%;超声弹性成像的敏感性、特异性和准确性分别为82.3%、87.2%和85.7%;超声+弹性成像敏感性、特异性和准确性分别为92.4%、93%和92.9%。敏感性:超声+超声弹性成像均高于常规超声、钼靶X线摄影和超声弹性成像(均P0.05);常规超声、钼靶X线摄影和超声弹性成像的敏感性比较差异无统计学意义(均P0.05)。特异性及准确性:超声、超声弹性成像均高于钼靶X线摄影(均P0.05);超声+超声弹性成像均高于常规超声、钼靶X线摄影和超声弹性成像(均P0.05);超声与超声弹性成像比较差异无统计学意义(P0.05)。结论常规超声无创、可重复性强,敏感性及特异性较高,可作为检查乳腺疾病的首选检查手段;钼靶X线摄影发现微小钙化优势显著;超声弹性成像有助于提高超声乳腺检查的准确性。超声联合弹性成像的综合应用,是评估触诊阴性乳腺病灶良、恶性的新方法,可提高早期乳腺癌的检出率。
Objective To analyze the diagnostic values of conventional ultrasound, mammography and ultrasound combined with elasticity in nonpalpable breast lesions, and to improve the detection rate of early breast cancer. Methods Results of conventional ultrasound, mammography and ultrasound combined with elasticity were analyzed and compared with histopathologic findings in 238 patients with nonpalpable breast lesions (266 lumps, including 79 malignant lumps and 187 benign lumps). Results The sensitivity,specificity and accuracy were, respectively, 79.8%, 75.9% and 77.1% for mammography, 77.2%, 86.1% and 83.5% for conventional ultrasound, 82.3%, 87.2% and 85.7% for elastography, and 92.4%, 93%and 92.9%for ultrasound combined with elasticity. The ultrasound combined with elasticity had higher sensitivity, specificity and accuracy than conventional ultrasound, mammography and elastography (P 0.05).The specificity and accuracy of conventional ultraso-und or elastography were significantly higher t